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What is the relation among physician workload, quality of care, and efficiency? To answer this question, researchers in Delaware conducted a retrospective cohort study of 20,241 inpatient admissions to their (primarily nonteaching) hospitalist services at two hospitals (1 tertiary care, 1 community; 1071 total beds). Outcomes were adjusted for multiple factors, including severity of illness, provider continuity, hospital occupancy, and test turnaround time.
On average, hospitalists managed 15 patients and accrued 29 Relative Value Units (RVUs) billed daily. As census and RVUs increased, both hospital length of stay (LOS) and cost of hospitalization increased. Cost per hospitalization and LOS increased for each additional patient managed, alt…