Medical Consults for Surgical Patients Varies Widely
(HealthDay News) — Use of medical consultations for surgical patients varies widely among hospitals, according to a study published online August 4 in JAMA Internal Medicine.
Lena M. Chen, MD, from the University of Michigan in Ann Arbor, and colleagues analyzed the use of medical consults among fee-for-service Medicare patients undergoing colectomy or total hip replacement (THR) between January 1, 2007, and December 31, 2010, at U.S. acute care hospitals.
The researchers found that more than half of patients undergoing colectomy or THR received at least one medical consultation while hospitalized (69 and 63%, respectively). Patients had a median of nine consultant visits for colectomy and three for THR. There was wide variation among hospitals in the likelihood of having at least one medical consultation (interquartile range, 50–91% for colectomy and 36–90% for THR). Greater use of medical consultation for colectomy was seen in nonteaching (adjusted risk ratio, 1.14) and for-profit (adjusted risk ratio, 1.10) settings. For colectomy patients without complications, variation in medical consultation use was greater, compared with those with complications.
"Understanding the value of medical consultations will be important as hospitals prepare for bundled payments and strive to enhance efficiency," the authors write.
One author disclosed financial ties to a company providing hospital quality and cost-efficiency consulting.