Does Experience Influence Hospitals’ Resource Use in Treating Alcohol and Other Drug Diagnoses?

Previous studies
May 1, 2007e efficient
and effective cardiac, cancer, and surgical care. To investigate
whether a hospital’s experience with alcohol and other drug diagnoses
or its teaching status impacts resource use, researchers analyzed
national data from the 1996 Healthcare Costs and Utilization Project
and other large administrative databases.

In analyses adjusted for multiple hospital (e.g., number of beds, ownership,
case mix index) and patient (e.g., age, sex, race, secondary diagnoses) characteristics,

• relative
  experience (proportion of alcohol- and drug-related admissions
  to total admissions) was significantly associated with lower
  charges but also associated (borderline significance) with greater
  length of stay;
• teaching
  hospital status was not significantly associated with either
  charges or length of stay.

Comments:

The authors speculated
that the lower charges and longer lengths of stay in high volume hospitals
might have resulted from managing patients with substance-related
disorders in less expensive settings (e.g., wards rather than ICUs).
They did not address quality of care, readmissions, or other outcomes.
Thus, whether this less expensive care leads to better or worse clinical
outcomes remains unknown.

Peter
D. Friedmann, MD, MPH

Reference:

Bramble JD, Sakowski
H, Rich EC, et al. Resource use in treating alcohol- and drug-related
diagnoses. Does teaching status and experience matter? J Gen Intern
Med. 2004;19(1):36–42.
(view
abstract)