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. Patient exclusions were any immunosuppressive illness or therapy within the past 3 months, comfort care only, or care provided by house staff. Patient variables of age, length of stay (LOS), time to initial antibiotic therapy, blood cultures drawn, use of deep venous thrombosis (DVT) prophylaxis, administration of pneumococcal vaccine or documentation of ineligibility for it, and name of attending physician were collected. Dichotomous variables were compared using chi(2)-analysis, and continuous variables were compared using the Student t test.

Results: A total of 158 patients were treated by 58 physicians; 68 patients by 12 hospitalists and 90 patients by 46 nonhospitalists. Patients did not differ in age, LOS, likelihood of receiving timely antibiotics, or having blood cultures drawn before antibiotics. Hospitalist patients were more likely to have been given inpatient DVT prophylaxis (96.9% vs 61.9%; P < .001) and to have had a pneumococcal vaccine administered or a documented reason why it was not given (88.2% vs 65.6%; P = .001).

Conclusion: This is the first study to suggest that pneumonia patients cared for by hospitalists were more likely to receive 2 important quality care processes.