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Physicians' response to length-of-stay profiling
J H Evans1, Y Hwang, N Nagarajan
1Joseph M. Katz Graduate School of Business, University of Pittsburgh, Pennsylvania 15260, USA.
Medical Care
|November 1, 1995
Summary
Physician profiling significantly increased the number of doctors meeting length-of-stay benchmarks. Doctors initially below the benchmark reduced patient stays more, particularly for intermediate severity cases, suggesting profiling
Area of Science:
- Healthcare Management
- Health Economics
- Medical Informatics
Background:
- Hospitals face cost reduction pressures.
- Physician profiling is a strategy to compare physician resource consumption against benchmarks.
- Patient length of stay is a key metric for hospital efficiency.
Purpose of the Study:
- To analyze the effectiveness of physician patient length-of-stay profiling in a hospital setting.
- To determine the impact of profiling on physicians' ability to meet length-of-stay benchmarks.
- To identify factors influencing the success of length-of-stay profiling.
Main Methods:
- Analysis of 24,000 patient records over 42 months, comparing pre- and post-profiling periods.
- Statistical tests controlled for physician, diagnosis-related group (DRG), and patient severity.
- Examined changes in physician performance against length-of-stay benchmarks.
Main Results:
- A significant increase in physicians achieving length-of-stay benchmarks post-profiling.
- Physicians initially below the benchmark showed greater reductions in patient length of stay.
- Reductions were most pronounced in intermediate severity cases and high-impact DRGs.
Conclusions:
- Physician length-of-stay profiling effectively reduces average patient stays.
- Tailoring benchmarks for different physicians could improve overall participation.
- Combining profiling with process improvement initiatives is crucial for cost reduction.