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A look at patient encounters

February 2015

Published in the February 2015 issue of Today’s Hospitalist

WHAT KINDS OF PATIENTS do hospitalists spend their days seeing? According to data from the 2014 Today’s Hospitalist Compensation & Career Survey, about half of hospitalists’ daily encounters are with existing patients, and about three-quarters are billed as admissions (vs. observation status). And the number of patients in the hospital being seen by hospitalists, as opposed to primary care physicians and specialists, is large and growing. Here’s a look at the type of patients full-time hospitalists who treat adults are seeing.

A breakdown of encounters
When we asked hospitalists to identify what types of patient encounters make up their day, the clear winner was not exactly a surprise. Existing patients accounted for just under half of hospitalists” day-to-day patient interactions. New patients, by comparison, accounted for 16% of patient encounters, while admissions accounted for 19% of encounters and discharges accounted for 18%.

But not all the patients that hospitalists bill for are inpatients. According to our data, more than one-quarter (26%) of patients seen by hospitalists are billed on an outpatient basis as observation patients.

Who’s admitting?
Of patients with inpatient status, hospitalists are admitting the vast majority of them. Respondents to our survey said that primary care physicians and subspecialists admit just under 20% of patients to their hospitals, with hospitalists admitting more than 80%.

Three years earlier, in 2011, by comparison, our survey found that hospitalists were responsible for admitting 70% of their hospitals’ inpatients. And in 2013, our survey found that 74% of inpatients were admitted by hospitalists, not other specialties. The data from our surveys seem to show that hospitalists are admitting more and more of the patients coming to their hospitals, but we need more data from future surveys to substantiate that conclusion.

And this year’s data uncovered an interesting regional trend in the percentage of patients that hospitalists admit.

The Pacific region leads the pack, with hospitalists there saying they admit more than 90% of their facilities’ patients. In the Midwest, Mountain and Southwest regions, by comparison, hospitalists report admitting less than 80% of the patients in their hospitals.