Effects of caregiver specialty on cost and clinical outcomes following hospitalization for heart failure

Kishore J. Harjai, Louis Marie Boulos, Frank W. Smart, Tansel Turgut, Marie A. Krousel-Wood, Dwight D. Stapleton, Mandeep R. Mehra, Joseph P. Murgo, Hector O. Ventura

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

In 614 consecutive hospitalizations with the primary discharge diagnosis of diagnosis-related group (DRG) 127 (heart failure and shock), we sought to assess the effect of caregiver specialty (generalist, n = 217; cardiologist, n = 397) on hospital costs, length of stay, and in-hospital mortality. Patients treated by cardiologists were younger (68 vs 71 years) and less likely to have hypertension (52% vs 61%), but were more likely to be men (61% vs 44%), require an intensive care stay (13% vs 5%), have coronary artery disease (49% vs 23%), have a left ventricular ejection fraction <40% (74% vs 49%), and have lower systolic (132 vs 146 mm Hg)and diastolic (76 vs 81 mm Hg) blood pressures on admission. Predictors of acute disease severity were similarly distributed between the 2 groups. No difference was found between patients treated by cardiologists versus those treated by generalists with respect to crude or adjusted hospital cost, length of stay, and in-hospital mortality. However, in subsets of patients who required intensive care during hospitalization (n = 64), as well as those who did not (n = 550), care by cardiologists was associated with a lower adjusted hospital cost. Any potential cost savings that could have accrued from care by cardiologists was, however, negated by the higher proportion of patients treated by cardiologists who required intensive care during hospitalization. We conclude that when differences in clinical variables are adjusted, care by cardiologists versus generalists is associated with similar or lower hospital cost for patients with DRG 127. Our findings challenge the notion that in- patient care provided by specialists is more expensive than that provided by generalists.

Original languageEnglish (US)
Pages (from-to)82-85
Number of pages4
JournalAmerican Journal of Cardiology
Volume82
Issue number1
DOIs
StatePublished - Jul 1 1998
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Effects of caregiver specialty on cost and clinical outcomes following hospitalization for heart failure'. Together they form a unique fingerprint.

  • Cite this

    Harjai, K. J., Boulos, L. M., Smart, F. W., Turgut, T., Krousel-Wood, M. A., Stapleton, D. D., Mehra, M. R., Murgo, J. P., & Ventura, H. O. (1998). Effects of caregiver specialty on cost and clinical outcomes following hospitalization for heart failure. American Journal of Cardiology, 82(1), 82-85. https://doi.org/10.1016/S0002-9149(98)00234-3