Hospital Care and Medical Utilization After Discharge
Authors: David O. Meltzer, Jeanette W. Chung
Journal: Annals of Internal Medicine (2011)

Letters15 November 2011Hospital Care and Medical Utilization After DischargeDavid O. Meltzer, MD, PhD and Jeanette W. Chung, PhDDavid O. Meltzer, MD, PhDFrom The University of Chicago, Chicago, IL 60617.Search for more papers by this author and Jeanette W. Chung, PhDFrom The University of Chicago, Chicago, IL 60617.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-10-201111150-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The potential for bias in the results of Kuo and Goodwin's study (1) deserves further discussion. The statistically significant differences the authors found in the observable attributes of patients of hospitalists and those of nonhospitalists are consistent with the findings that we have published describing determinants of whether hospitalists or nonhospitalists provide care. For example, we have found that attributes of the PCP practice predict the use of hospitalists (2, 3).Kuo and Goodwin conclude that the differences they observed in patient attributes were “small,” which should allay concern that propensity score analysis cannot control for unobservable ...References1. Kuo YF, Goodwin JS. Association of hospitalist care with medical utilization after discharge: evidence of cost shift from a cohort study. Ann Intern Med. 2011;155:152-9. [PMID: 21810708] LinkGoogle Scholar2. Meltzer DO, Chung JW. U.S. trends in hospitalization and generalist physician workforce and the emergence of hospitalists. J Gen Intern Med. 2010;25:453-9. [PMID: 20352367] CrossrefMedlineGoogle Scholar3. Meltzer DO, Chung JW. Coordination, Switching Costs and the Division of Labor in General Medicine: An Economic Explanation for the Emergence of Hospitalists in the United States. Working Paper No. 16040. Cambridge, MA: National Bureau of Economic Research; May 2010. Accessed at www.nber.org/papers/w16040 on 12 October 2011. Google Scholar4. White HL, Glazier RH. Do hospitalist physicians improve the quality of inpatient care delivery? A systematic review of process, efficiency and outcome measures. BMC Med. 2011;9:58. [PMID: 21592322] CrossrefMedlineGoogle Scholar5. Meltzer D, Manning WG, Morrison J, Shah MN, Jin L, Guth T, et al. Effects of physician experience on costs and outcomes on an academic general medicine service: results of a trial of hospitalists. Ann Intern Med. 2002;137:866-74. [PMID: 12458986] LinkGoogle Scholar6. Cutler D. The incidence of adverse medical outcomes under prospective payment. Econometrica. 1995;63:29-50. CrossrefGoogle Scholar Author, Article, and Disclosure InformationAuthors: David O. Meltzer, MD, PhD; Jeanette W. Chung, PhDAffiliations: From The University of Chicago, Chicago, IL 60617.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of Physician Experience on Costs and Outcomes on an Academic General Medicine Service: Results of a Trial of Hospitalists David Meltzer , Willard G. Manning , Jeanette Morrison , Manish N. Shah , Lei Jin , Todd Guth , and Wendy Levinson Association of Hospitalist Care With Medical Utilization After Discharge: Evidence of Cost Shift From a Cohort Study Yong-Fang Kuo and James S. Goodwin Hospital Care and Medical Utilization After Discharge Jean-Sebastien Rachoin Hospital Care and Medical Utilization After Discharge Daniel J. Brotman , Romsai T. Boonyasai , and Amy Deutschendorf Hospital Care and Medical Utilization After Discharge Arun K. Raman Hospital Care and Medical Utilization After Discharge Dimitriy Levin and Jeffrey J. Glasheen Hospital Care and Medical Utilization After Discharge Joshua Freeman Hospital Care and Medical Utilization After Discharge Yong-Fang Kuo and James S. Goodwin Hospital Care and Medical Utilization After Discharge David M. Mitchell Metrics Cited byCharacteristics of primary care providers who adopted the hospitalist model from 2001 to 2009 15 November 2011Volume 155, Issue 10 Page: 719-720 Keywords Comparative effectiveness research Conflicts of interest Hospitalists Observational studies Patients Specificity ePublished: 15 November 2011 Issue Published: 15 November 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...