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Should a Cardiologist be the Principal Attending Physician or the Consultant to a Hospitalist or General Internist

George Everett1, Nizam Uddin2

  • 1Program Director, Internal Medicine Residency Program, Florida Hospital Medical Center, 2501 North Orange Avenue, Orlando, FL 32804. E: george.everett.md@flhosp.org.

The American Heart Hospital Journal
|May 20, 2014
PubMed

Insights

For hospitalized cardiovascular disease patients, cardiologists as attending physicians may improve efficiency and lower costs, especially for procedures. Mortality and readmissions showed no significant differences among physician groups.

Area of Science:

  • Cardiology
  • Health Services Research
  • Hospital Administration

Background:

  • Cardiologists can serve as attending physicians or consultants for hospitalized patients with cardiovascular diseases.
  • Determining the optimal physician role (cardiologist, hospitalist, or general internist) is crucial for healthcare quality and efficiency.

Purpose of the Study:

  • To compare the efficiency and quality of care provided by cardiologists, general internists, and hospitalists in managing hospitalized cardiovascular disease patients.
  • To evaluate differences in hospital cost, length of stay, mortality, and 30-day readmissions based on the attending physician's specialty.

Main Methods:

  • A retrospective cohort study analyzed 15,113 patients across 11 cardiovascular diagnosis groups.
  • Hospital cost, length of stay, mortality, and 30-day readmissions were compared between attending physicians: hospitalists, general internists, and cardiologists.
  • Statistical adjustments were made for patient demographics and disease severity.

Main Results:

  • Cardiologists demonstrated substantially lower hospital costs and shorter lengths of stay compared to internists and hospitalists.
  • These efficiency gains were particularly pronounced in diagnosis groups involving cardiovascular procedures.
  • No statistically significant differences in mortality or 30-day readmission rates were observed among the physician groups.

Conclusions:

  • Cardiologists may offer greater efficiency in managing specific cardiovascular diseases, particularly when procedures are required.
  • The choice of attending physician can impact healthcare resource utilization without adversely affecting patient mortality or readmission rates.
  • Findings suggest a potential benefit of utilizing cardiologists as attending physicians for improved efficiency in cardiovascular care.

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