NCPA - National Center for Policy Analysis

Hospitalist Programs Result in Significant Cost Savings

February 4, 2002

"Hospitalists" are a new breed of physician providing inpatient care in a hospital in place of primary care physicians. The hospitalist model of inpatient care is relatively young, and has experienced tremendous growth over the last few years. This growth has important clinical, financial, educational and policy implications. To analyze the impact of hospitalists on the health care system, researchers recently review data regarding the effect of hospitalists on resource use, quality of care, satisfaction and teaching.

Most of the studies researchers reviewed found that implementation of hospitalist programs were associated with significant reductions in resource use:

  • The average decrease in a patient's hospital costs was 13.4 percent.
  • Average decrease in a patient's length of stay was 16.6 percent.
  • The few studies that failed to demonstrate reductions usually used atypical control groups.
  • However, the results were inconsistent for improved outcomes, such as inpatient mortality and readmission rates.

Patient satisfaction was generally preserved, while limited data supports the claim that there are positive effects on teaching. Previous research by the authors found some negative reactions from those who worried about the "purposeful discontinuity of care" introduced by the hospitalist model when a hospital physician took over the care of a patient from the patient's primary care physician. Although concerns about inpatient-outpatient information transfer remain, recent physician surveys indicate general acceptance of the model.

Source: Robert M. Wachter and Lee Goldman, "The Hospitalist Movement 5 Years Later," Journal of the American Medical Association, January 23/30, 2002.


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