Evidence map›Paper›PMID 33495887›Full record

ArticleJournal of general internal medicine2021

Hospitalization and Post-hospitalization Outcomes Among Teaching Internal Medicine, Employed Hospitalist, and Locum Tenens Hospitalist Services in a Tertiary Center: a Prospective Cohort Study.

Moaath K Mustafa Ali, Marwa M Sabha, Sarah K Mustafa, Momen Banifadel, Sami Ghazaleh, Kanana M Aburayyan, Marcel T Ghanim, Mohammed T Awad, Damynus N Gekonde, Amala R Ambati and 6 more

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Article in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Moaath K Mustafa AliDepartment of Medicine, University of Toledo/Promedica Toledo Hospital, Toledo, OH, USA. moaath_mustafa@yahoo.com.ORCID 0000-0003-3289-2333
Marwa M SabhaDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Sarah K MustafaDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Momen BanifadelDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Sami GhazalehDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Kanana M AburayyanDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Marcel T GhanimDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Mohammed T AwadDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Damynus N GekondeDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Amala R AmbatiDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Ahmad RamahiDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Ahmed M ElzanatyDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Zeid NesheiwatDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Pinang M ShastriDepartment of Medicine, University of Toledo, Toledo, OH, USA.
Mohammad Al-SarieDepartment of Medicine, University of Toledo, Toledo, OH, USA.
John McGreadyDepartment of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are no prospective studies comparing hospitalization and post-hospitalization outcomes between teaching internal medicine services and non-teaching hospitalists, and no prospective studies comparing these outcomes between locum and employed hospitalists.

objectiveTo compare the length of stay, hospital costs readmission rate, and mortality rate in patients treated by teaching internal medicine services vs. hospitalists and among patients treated by locum vs. employed hospitalists.

designProspective cohort study. Propensity score was used to obtain weighted estimates.

settingReferral center. PATIENTS: All patients 18 years and older admitted to internal medicine services.

interventionTreatment by teaching internal medicine services vs. hospitalists. Treatment by locum hospitalists vs. employed hospitalists. MAIN MEASURES: Primary outcome was adjusted length of stay and secondary outcomes included hospital cost, inpatient mortality, 30-day all-cause readmission, and 30-day mortality. KEY

resultsA total of 1273 patients were admitted in the study period. The mean patient age was 61 ± 19 years, and the sample was 52% females. Teaching internal medicine physicians admitted 526 patients and non-teaching hospitalists admitted 747 patients. Being seen exclusively by teaching internal medicine physicians comports with a shorter adjusted hospital stay by 0.6 days (95% CI - 1.07 to - 0.22, P = .003) compared to non-teaching hospitalists. Adjusted length of stay was 1 day shorter in patients seen exclusively by locums compared to patients seen exclusively by employed services (95% CI - 1.6 to - 0.43, P < .001) with an adjusted average hospital cost saving of 1339 dollars (95% CI - 2037 to - 642, P < .001). There was no statistically significant difference in other outcomes.

conclusionsTeaching internal medicine services care was associated with a shorter stay but not with increased costs, readmission, or mortality compared to non-teaching services. In contrary to the "expected," patients treated by locums had shorter stays and decreased hospital costs but no increase in readmissions or mortality.

Indexed as

HospitalistsAdultAgedAged, 80 and overFemaleHospital CostsHospitalizationHumansMaleMiddle AgedPatient ReadmissionProspective StudiesRetrospective Studieshospital costshospitalistlength of staylocummortalitypatient readmissionteaching internal medicine

Identifiers

PMID33495887
PMCPMC7832420

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.