Jerome S. Tannenbaum, MD, PhD
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Tannenbaum J.; Hospitalist Care. Ann Intern Med. 2003;139:703-704. doi: 10.7326/0003-4819-139-8-200310210-00021
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Published: Ann Intern Med. 2003;139(8):703-704.
TO THE EDITOR:
The studies by Auerbach and Meltzer and colleagues (1, 2) attempted to show that the clinical experience of hospitalists improved over time and that this improvement explained the modest but statistically significant reduction in mortality, shorter lengths of stay, and lower hospital costs observed for hospitalists' patients compared with those of nonhospitalists. As the related editorial pointed out (3), the improved results in the second year of each study, most of which were related to shorter lengths of stay and lower costs, could also be attributed to improved logistic management of care, which would reflect hospitalists' increased understanding of hospital resources. It was not clear from Auerbach and colleagues' study how many years the hospitalists had been associated with the institution. Meltzer and colleagues seem to have converted nonhospitalists to hospitalists for the purpose of the study. Again, the relative familiarity of hospitalist physicians with the institution compared with physicians who were not selected as hospitalists (the control group) was not addressed.
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