Economic analysis of the Hospitalist Program in the Saskatoon Health Region

Abstract

The Saskatoon Health Region has initiated a review board to evaluate the effectiveness of its relatively new hospitalist program. Under the program, physicians do not keep regular office hours for which to see patients. Instead they work out of the hospital and primarily care for inpatients. Studies have found this program to increase efficiency in the delivery of care in other countries and regions without reducing the quality of the services provided, as measured by patient satisfaction, continuity of care, and readmission and mortality rates. This thesis examines the hospitalist program’s effects on inpatient length of stay, readmissions, and rate of mortality. We find that the additional funding spent on the program does not significantly affect patient readmission or mortality rates. However there is evidence that the program has increased patient length of stay among those with atypically long hospital stays. Over the entire sample patient length of stay is however shown to decrease with time implying the physicians are becoming more efficient in diagnosis of illnesses and delivery of care, although this result cannot be attributed to the hospitalist program. We also identify a reduction in length of stay due to the change in physician payment structure, from fixed to fixed plus variable pay among patients with typical lengths of stay. Through this reduction in patient length of stay, patient throughput can be increased and more patients can receive care in the Saskatoon Health Region.