Researchers at Sungkyunkwan University in South Korea and the University of Texas Medical Branch recently published in the journal AJMC that electronic health records (EHR) and hospitalist care are both factors that can influence a respiratory patient’s length of stay in hospitals. The study is entitled “The Combined Effect of the Electronic Health Record and Hospitalist Care on Length of Stay.”
The term “hospitalist” refers to physicians whose primary focus is the general medical care of hospitalized patients. The number of hospitalists and patients cared by them has been steadily increasing over the years. A hospitalist is expected to be more efficient and effective in starting the appropriate healthcare treatment for the patient, as well as preventing complications of hospitalization, potentially reducing the patient’s length of stay in the hospital. EHR can also contribute to effective hospital care by improving the communication and medical information transfer between health providers. Studies have reported that EHR is linked to a lower length of stay and to improved quality of care.
In this study, the impact of the combined effect of EHR adoption and hospitalist care regarding the length of stay in healthcare services was assessed. The research team focused on respiratory diseases, as the continuity of care is known to be quite important in this type of disease, namely in pneumonia, bronchitis and chronic obstructive pulmonary disease (COPD).
Researchers conducted a retrospective study based on data from the Healthcare Information and Management Systems Society (HIMSS) and a sample of Medicare beneficiaries. In total, researchers assessed 20,862 admission of patients with respiratory disease that were cared by hospitalists and 28,714 by non-hospitalists in 2985 different hospitals in the United States in 2009.
Researchers found that the reduced length of stay linked to hospitalist care was greater than the one associated to EHR adoption. EHR adoption significantly improved care efficiency only in hospitals where fewer patients were cared by hospitalists, indicating that EHR may complement hospitalist care in medical services with a relatively small number of hospitalists. Nonetheless, researchers found a significant interaction between EHR adoption and hospitalist care regarding the length of stay, where the presence of one lessened the effect of the other. In fact, the reduced length of stay associated to hospitalist care in hospitals with a complete EHR was found to be smaller (0.166 days) in comparison with hospitals without a complete EHR (0.599 days).
The research team concluded that a reduced length of stay in patients with respiratory diseases has a greater association to hospitalist care in comparison with the association to EHR adoption. However, the combined effect of both hospitalist care and complete EHR adoption resulted in a substantial total reduction in length stay of 0.61 days, which represents 613 bed days saved for 1,000 discharges. The team suggests that a combination of EHR adoption and hospitalist care should be considered by hospital administrators.