The hospital work of a family practice group in a medium size community in New England

This study examines the hospital work of four family physicians in group practice in a community of 45,000 in north central Massachusetts. During the study year, these four physicians assumed primary management responsibility for 1,021 hospitalizations for an average of 255 admissions per physician. Most admissions (98 percent) were to a 242-bed community hospital, and these 997 admissions were studied in detail. Obstetrical admissions accounted for 21 percent of the total (not counting newborns), with 169 deliveries. Pediatric admissions (newborn to age 21 years) accounted for 42 percent of the total. Sixteen percent were patients over 65 years of age. One or more consultations were requested in 14 percent of the admissions. Some form of cardiovascular disease constituted the most frequent discharge diagnoses, with newborn care and pregnancy related diagnoses second and third. The four physicians were compared to each other for variables including age/sex profile, discharge diagnoses, length of stay, consultations requested, and admission ratio per ambulatory encounter. In spite of their differences in training and length of time in practice, the four physicians were found to be similar to one another on most of these dimensions.