Assessing the Complexity of Inpatient Care Managed by Endocrinologists in a Tertiary Care Teaching Hospital

We aimed to analyze the complexity of cases managed by the inpatient endocrinology team at a tertiary care teaching hospital.

Data were extracted from the electronic health records from 2019 through 2023, focusing on relative-weight (RW) data of the Medicare Severity Diagnosis-Related Groups (MS-DRG) for inpatients seen by the endocrinology, infectious diseases, cardiology, nephrology, and hospital internal medicine services. Multivariable linear regression was used to assess the association between MS-DRG RW and specialty.

During the 5-year time frame, the inpatient endocrinology service consulted on a total of 7761 cases. Of these, 5831 cases (76%) were related to diabetes, and 1830 (24%) were for other endocrine-related diagnoses. After adjusting for year of hospital discharge, multivariable regression analyses showed that the mean MS-DRG RWs of cases evaluated by the inpatient endocrinology team were significantly higher than those of cases evaluated by infectious diseases, cardiology, nephrology, or hospital internal medicine alone (all P < .001).

In this single-site analysis, most inpatient endocrinology consultations were for diabetes. The results showed that cases involving endocrinology had significantly higher MS-DRG RWs than those in which endocrinology was not involved. This information could have practical implications for workforce allocation and the resources needed to assure safe and effective treatment of the endocrine inpatient in need of complex care.