Use of hospitalists by Medicare beneficiaries: a national picture

Area of Science:

• Health Services Research
• Medical Practice Analysis
• Geriatric Care

Background:

• Hospitalists are physicians who focus on general medical care for hospitalized patients.
• Understanding hospitalist demographics and practice patterns is crucial for healthcare planning.
• Medicare beneficiaries represent a significant and growing segment of the US population requiring inpatient care.

Purpose of the Study:

• To characterize hospitalists serving Medicare beneficiaries.
• To quantify the extent of hospitalist involvement in Medicare admissions.
• To analyze trends in hospitalist utilization from 2009 to 2011.

Main Methods:

• Utilized Medicare claims data from 2009 and 2011.
• Integrated data with the Provider Enrollment, Chain, and Ownership System (PECOS).
• Developed the Medicare Data on Physician Practice and Specialty (MD-PPAS) to identify hospitalists based on attending physician role for Medicare admissions.

Main Results:

• In 2011, hospitalists represented 4.4% of all physicians serving Medicare beneficiaries.
• Hospitalists were more likely to be female, younger, and in larger practices compared to other physicians.
• Hospitalists served as attending physicians for over a quarter of Medicare admissions, with higher rates for medical (31.8%) versus surgical (11.3%) admissions.
• The proportion of medical admissions with a hospitalist attending increased by approximately 25% between 2009 and 2011.

Conclusions:

• This study provides a current and comprehensive estimate of hospitalist use among Medicare beneficiaries.
• The developed methodology allows for better identification of hospitalists in claims data.
• This improved identification will support future research on hospitalist impact on healthcare quality and costs.