TY - JOUR
T1 - Resource Use in Treating Alcohol- and Drug-related Diagnoses
T2 - Does Teaching Status and Experience Matter?
AU - Bramble, James D.
AU - Sakowski, Henry
AU - Rich, Eugene C.
AU - Esterbrooks, Dennis
N1 - Funding Information:
Inpatient Sample (NIS) is part of the Healthcare Cost and Utilization Project (HCUP) sponsored by the Agency for Healthcare Research and Quality (AHRQ). The HCUP is a partnership between federal and state government agencies, as well as private industry. The NIS represents a 20% sample of all U.S. community hospitals stratified to include a proportionate number of hospitals for each stratum. In 1996, 19 states and over 900 hospitals participated, with over 6.5 million discharges. States participating during this time included Arizona, California, Colorado, Connecticut, Florida, Illinois, Iowa, Kansas, Maryland, Massachusetts, Montana, New Jersey, New York, Oregon, Pennsylvania, South Carolina, Tennessee, Washington, and Wisconsin. We extracted patient level data on diagnosis, demographics, hospital charges, and payer source.
PY - 2004/1
Y1 - 2004/1
N2 - OBJECTIVE: This study examined the variations in hospital resource use in the treatment of alcohol and drug diagnoses. Specifically, the study tested 2 hypotheses: 1) patients treated in teaching hospitals will have shorter lengths of stay and lower hospital charges than patients treated in nonteaching hospitals; and 2) patients treated in hospitals with more experience treating these conditions will have shorter lengths of stay and lower hospital charges. DESIGN: A retrospective cross-sectional study design used data from the 1996 Health Care Utilization Project to test the proposed hypotheses. PATIENTS/PARTICIPANTS: The population for this study consisted of patients over 18 years old with an acute alcohol-or drug-related discharge diagnostic related group code. MEASUREMENT AND MAIN RESULTS: The variables of interest were teaching hospital status, as defined by the Council of Teaching Hospitals, and hospital experience, defined as the ratio of alcohol- and drug-related diagnoses to the hospital's total admissions. Measures of hospital resource use included the patient's length of stay and total hospital charges. Patients treated at hospitals with relatively more experience in treating alcohol- and drug-related diagnoses had 10.3% ($321) lower total charges (P = .017). CONCLUSIONS: Similar to research for high-volume surgical hospitals, these findings confirm that hospitals that have greater experience with complex medical conditions such as alcohol and drug intoxication and withdrawal may be more efficient. This important finding provides a rationale for further exploration of the key factors associated with higher quality and more efficient care for complex medical conditions.
AB - OBJECTIVE: This study examined the variations in hospital resource use in the treatment of alcohol and drug diagnoses. Specifically, the study tested 2 hypotheses: 1) patients treated in teaching hospitals will have shorter lengths of stay and lower hospital charges than patients treated in nonteaching hospitals; and 2) patients treated in hospitals with more experience treating these conditions will have shorter lengths of stay and lower hospital charges. DESIGN: A retrospective cross-sectional study design used data from the 1996 Health Care Utilization Project to test the proposed hypotheses. PATIENTS/PARTICIPANTS: The population for this study consisted of patients over 18 years old with an acute alcohol-or drug-related discharge diagnostic related group code. MEASUREMENT AND MAIN RESULTS: The variables of interest were teaching hospital status, as defined by the Council of Teaching Hospitals, and hospital experience, defined as the ratio of alcohol- and drug-related diagnoses to the hospital's total admissions. Measures of hospital resource use included the patient's length of stay and total hospital charges. Patients treated at hospitals with relatively more experience in treating alcohol- and drug-related diagnoses had 10.3% ($321) lower total charges (P = .017). CONCLUSIONS: Similar to research for high-volume surgical hospitals, these findings confirm that hospitals that have greater experience with complex medical conditions such as alcohol and drug intoxication and withdrawal may be more efficient. This important finding provides a rationale for further exploration of the key factors associated with higher quality and more efficient care for complex medical conditions.
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U2 - 10.1111/j.1525-1497.2004.20803.x
DO - 10.1111/j.1525-1497.2004.20803.x
M3 - Article
C2 - 14748858
AN - SCOPUS:1242337289
VL - 19
SP - 36
EP - 42
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
SN - 0884-8734
IS - 1
ER -