Hospitalists and “cost shifting”

In this large analysis of Medicare fee for service patients with a current PCP, researchers found that those hospitalized under the care of their PCP were more likely to be discharged home, and less likely to incur post-discharge long term care costs. Although total hospital costs were lower for hospitalists than PCPs, the total 30 days costs were higher with hospitalists, implying a “cost shifting” from inpatient to post-discharge care. They found hospitalist patients were also more likely to be seen in the ED and be readmitted than PCP patients. Although this study is limited by the inherent biases of retrospective analyses, it still raises concerns that hospitalists need to focus heavily on safe and effective transitions of care (abstract)

Danielle Scheurer

Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.

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