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Comparisons of Family Physicians and InternistsProcess and Outcome in Adult Patients at a Community Hospital

 

作者: Peter Franks,   John Dickinson,  

 

期刊: Medical Care  (OVID Available online 1986)
卷期: Volume 24, issue 10  

页码: 941-948

 

ISSN:0025-7079

 

年代: 1986

 

出版商: OVID

 

关键词: primary care physicians;gatekeeper;quality of care;hospitalized patients

 

数据来源: OVID

 

摘要:

In view of the relatively high cost and mortality associated with hospitalization, 1,989 inpatients of family physicians and internists were compared with regard to length of stay, charges generated, charges generated per day, disposition (home, death, or other), number and type of diagnoses, and number of procedures. There were no interspecialty differences in mean length of stay (9 days), charges generated ($3,604), charges per day ($475), number of procedures done or disposition (79% went home, 9.5% died, and 11.5% had other placements). There were interspecialty differences in the type of diagnoses coded (chi-square = 52,P< 0.0001); family physicians tended to assign fewer diagnoses than internists (mean 3.08 versus 3.43,P< 0.0001). Review of a random sample of 50 charts of patients admitted to family physicians and a matched sample of charts of patients admitted to internists did not reveal any differences in either severity of illness on admission or rate of readmission. Multivariate adjustment for differences in case mix did not affect the direction or significance of the main findings. Similar findings were obtained whether using the hospital admission or the physician as the unit of analysis. The results are discussed in the context of related investigations in the ambulatory setting.

 

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