PCP care increases length of stay, reduces 30-day mortality

PCP care increases length of stay, reduces 30-day mortality PharmacoEconomics & Outcomes News 792, p22 - 2 Dec 2017 PCP care increases length of stay, reduces 30-day mortality Hospital care by patients’ own primary care physicians (PCPs) appears to increase the length of stay but reduce the 30-day mortality rate, according to findings of a retrospective US study published in JAMA Internal Medicine. Medicare Part A and Part B claims data for 560 651 hospital admissions across the US during 2013, for 20 common medical diagnoses in fee-for-service Medicare patients aged 66 years or over, were used to assess associations between physician types and outcomes including the number of inpatient consultations, length of stay, readmission rates and 30-day mortality. The physician type was hospitalist in 59.7% of admissions, PCP in 14.2% of admissions and other generalist in 26.1% of admissions. Compared with hospitalist care, consultations were more frequent with PCPs (relative risk [RR] 1.03; 95% CI 1.02, 1.05) and other generalists (RR 1.06; 95% CI 1.05, 1.07), and lengths of stay were longer with PCPs (adjusted incidence rate ratio [aIR] 1.12; 95% CI 1.11, 1.13) and generalists (aIR 1.06; 95% CI 1.05, 1.07). Discharge to home was more likely with PCP than specialist care (adjusted odds ratio [aOR] 1.14; 95% CI 1.11, 1.17) but less likely with generalist care (aOR 0.94; 95% CI 0.92, 0.96). Readmission rates at 7 and 30 days were similar with hospitalist and PCP care but higher with other generalists, while the 30-day mortality rate was lower with PCP versus hospitalist care (aOR 0.94; 95% CI 0.91, 0.97) and higher with other generalist care (aOR 1.09; 95% CI 1.07, 1.12). "Our results suggest that longitudinal contact with a patient may translate into meaningful differences in care patterns and patient outcomes. Novel models of care that integrate PCPs who care for patients in the ambulatory setting with their patients’ hospital care may yield substantial benefits in outcomes that are meaningful to patients," said the authors. Stevens JP, et al. Comparison of Hospital Resource Use and Outcomes Among Hospitalists, Primary Care Physicians, and Other Generalists. JAMA Internal Medicine : 13 Nov 2017. Available from: URL: http://doi.org/10.1001/ jamainternmed.2017.5824 803283336 1173-5503/17/0792-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Dec 2017 No. 792 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png PharmacoEconomics & Outcomes News Springer Journals

PCP care increases length of stay, reduces 30-day mortality

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Publisher
Springer International Publishing
Copyright
Copyright © 2017 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Pharmacoeconomics and Health Outcomes; Quality of Life Research; Health Economics; Public Health
ISSN
1173-5503
eISSN
1179-2043
D.O.I.
10.1007/s40274-017-4545-z
Publisher site
See Article on Publisher Site

Abstract

PharmacoEconomics & Outcomes News 792, p22 - 2 Dec 2017 PCP care increases length of stay, reduces 30-day mortality Hospital care by patients’ own primary care physicians (PCPs) appears to increase the length of stay but reduce the 30-day mortality rate, according to findings of a retrospective US study published in JAMA Internal Medicine. Medicare Part A and Part B claims data for 560 651 hospital admissions across the US during 2013, for 20 common medical diagnoses in fee-for-service Medicare patients aged 66 years or over, were used to assess associations between physician types and outcomes including the number of inpatient consultations, length of stay, readmission rates and 30-day mortality. The physician type was hospitalist in 59.7% of admissions, PCP in 14.2% of admissions and other generalist in 26.1% of admissions. Compared with hospitalist care, consultations were more frequent with PCPs (relative risk [RR] 1.03; 95% CI 1.02, 1.05) and other generalists (RR 1.06; 95% CI 1.05, 1.07), and lengths of stay were longer with PCPs (adjusted incidence rate ratio [aIR] 1.12; 95% CI 1.11, 1.13) and generalists (aIR 1.06; 95% CI 1.05, 1.07). Discharge to home was more likely with PCP than specialist care (adjusted odds ratio [aOR] 1.14; 95% CI 1.11, 1.17) but less likely with generalist care (aOR 0.94; 95% CI 0.92, 0.96). Readmission rates at 7 and 30 days were similar with hospitalist and PCP care but higher with other generalists, while the 30-day mortality rate was lower with PCP versus hospitalist care (aOR 0.94; 95% CI 0.91, 0.97) and higher with other generalist care (aOR 1.09; 95% CI 1.07, 1.12). "Our results suggest that longitudinal contact with a patient may translate into meaningful differences in care patterns and patient outcomes. Novel models of care that integrate PCPs who care for patients in the ambulatory setting with their patients’ hospital care may yield substantial benefits in outcomes that are meaningful to patients," said the authors. Stevens JP, et al. Comparison of Hospital Resource Use and Outcomes Among Hospitalists, Primary Care Physicians, and Other Generalists. JAMA Internal Medicine : 13 Nov 2017. Available from: URL: http://doi.org/10.1001/ jamainternmed.2017.5824 803283336 1173-5503/17/0792-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved PharmacoEconomics & Outcomes News 2 Dec 2017 No. 792

Journal

PharmacoEconomics & Outcomes NewsSpringer Journals

Published: Dec 2, 2017

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