Comparison of hospitalists and nonhospitalists regarding core measures of pneumonia care.

Objective: To examine whether compliance with national indicators of care differed amongst hospitalists and nonhospitalists.

Study Design: Retrospective, observational cohort study.

Methods: Patients admitted from September 2004 through January 2005 to a community teaching hospital with a principal diagnosis of community-acquired pneumonia were included.

Overuse of prothrombin and partial thromboplastin coagulation tests in medical inpatients.

Introduction: In the monitoring of anticoagulant therapy, prothrombin time (PT) is used to measure the effect of warfarin, whereas the partial thromboplastin time (PTT) measures the therapeutic effect of unfractionated heparin. Low molecular weight heparin (LMWH) does not require routine monitoring.

Objective: We collected data on the frequency of simultaneous PT and PTT requests, where only one or neither is indicated, and estimated the potential cost savings if ordering was appropriate.

Correlation between housestaff performance on the United States Medical Licensing Examination and standardized patient encounters.

Background: There is interest in the use of "standardized patients" to assist in evaluating medical trainees' clinical skills, which may be difficult to evaluate with written exams alone. Previous studies of the validity of observed structured clinical exams have found low correlation with various written exams as well as with faculty evaluations. Since the United States Medical Licensing Examination (USMLE) results are often used by training programs in the selection of applicants, we assessed the correlation between performance on an observed structured clinical exam and the USMLE, steps 1 and 2, for internal medicine housestaff.

Comparison of hospitalists and nonhospitalists in inpatient length of stay adjusting for patient and physician characteristics.

Objective: To determine the independent effect of hospitalist status upon inpatient length of stay after controlling for case mix, as well as patient-level and provider-level variables such as age, years since physician medical school graduation, and volume status of provider.

Design: Observational retrospective cohort study employing a hierarchical random intercept logistic regression model.

Setting: Tertiary-care teaching hospital.

Comparison of processes and outcomes of pneumonia care between hospitalists and community-based primary care physicians.

Objective: To compare medical care provided by hospitalists and primary care physicians to patients with community-acquired pneumonia in order to identify specific practices that might explain the improved efficiency of care provided by hospitalists.

Patients And Methods: We retrospectively reviewed the medical charts of 455 patients hospitalized with pneumonia at a community-based tertiary care center between January 1, 1998, and January 1, 1999. Exclusion criteria included human immunodeficiency virus infection, lung cancer, active tuberculosis, hospitalization within 7 days, length of stay (LOS) more than 14 days, and requirement of mechanical ventilation.