Eran Bellin, MD
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Bellin E. Hospitalists: Cost and Quality of Care. Ann Intern Med. 1999;130:450. doi: 10.7326/0003-4819-130-5-199903020-00009
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Published: Ann Intern Med. 1999;130(5):450.
TO THE EDITOR:
Although the notion of the effectiveness of a hospitalist has much intellectual appeal, Diamond and colleagues' study (1) contains many observations that deserve attention.
Of note, the medical service organization (MSO) practice, while improving its length of stay statistics dramatically, began with an appalling length of stay at baseline compared to that of their community colleagues (8.75 days compared with 6.68 days). Although the MSO practice, with the help of a hospitalist, dramatically reduced its patients' length of stay, the MSO physicians still did worse than their community peers (6.33 days compared with 6.23 days). The authors do not highlight the fact that even with a hospitalist, the MSO practice was more inefficient. The authors then identify a subgroup of community physicians with the most inefficient practice style and use this group as a comparison group. It seems strange that the authors would seek out as a control group those community physicians whose performance was so different from that of their peers.
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