Infectious Disease Specialists Improve Patient Outcomes

A first-of-its-kind study of the impact of infectious disease (ID) physician specialists on outcomes for patients hospitalized with severe infections found that such patients are 9% less likely to die in the hospital and 12% less likely to die after discharge if they are seen by an ID specialist for evidence-based recommendations on diagnosis and management.² The impact is more pronounced if they are seen by the specialist within 48 hours of hospital admission.

Researchers from Avalere Health and the Infectious Diseases Society of America (www.idsociety.org) examined fee-for-service Medicare claims from 2008 and 2009 for matched cohorts of more than 100,00 hospitalized patients with at least one of 11 common but serious infections who had interactions with ID specialists and 170,000 who did not. Although it is sometimes assumed that involving medical specialty consultants adds to costs, this study found that hospital and ICU lengths of stay were shorter and 30-day readmissions were reduced, says co-author Daniel McQuillen, MD, an ID specialist at Lahey Hospital and Medical Center in Burlington, Mass. Medicare charges and payments were not significantly different.

“We interact really well with thehospitalist group here,” Dr. McQuillen says. “We try to reinforce with our hospitalist group that our preference is to get involved early. If you do that, we’re very good at shepherding the patient through the transitions-of-care experience.

Post-discharge, the patient sees me in my office within a week, and I manage the handoff to the IV therapy service.”

Larry Beresford is a freelance writer in San Francisco, Calif.

References

1. Chang W, Maynard G, Clay B. Implementation of a computerized COPD inpatient pathway and transition pathway [abstract]. J Hosp Med. 2013;8 Suppl 1:709.
2. Schmitt S, McQuillen DP, Nahass R, et al. Infectious diseases specialty intervention is associated with decreased mortality and lower healthcare costs [published online ahead of print September 25, 2013]. Clin Infect Dis.
3. Torio CM, Andrews RM. National inpatient hospital costs: the most expensive conditions by payer, 2011. Healthcare Cost and Utilization Project Statistical Brief #160. Available at: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb160.jsp. Accessed October 26, 2013.
4. Herman B. Top 20 most expensive inpatient conditions. Becker’s Hospital Review. Oct. 9, 2013. Available at: http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/top-20-most-expensive-inpatient-conditions.html. Accessed October 26, 2013.