INFECTIOUS-DISEASES CONSULTATION - IMPACT ON OUTCOMES FOR HOSPITALIZED-PATIENTS AND RESULTS OF A PRELIMINARY-STUDY

In the absence of detailed and specific data on outcomes, specialists are thought to contribute excessively to the cost of care. Infectious diseases physicians are at further risk of heavy utilization of medica l resources because their patients often are those with serious compli cations or expensive underlying diseases (e.g., AIDS). By using readil y available information in a sophisticated computer database, we exami ned the crude economic impact of an inpatient infectious diseases cons ultation and identified important matching variables for more refined analysis, The study was performed at LDS Hospital (Salt Lake City), a tertiary care facility with four full-time infectious diseases physici ans. A total of 496 cases (patients who were seen by an infectious dis eases consultant) were matched with 3,117 controls (patients who were not seen by an infectious diseases consultant). Matching was performed on the basis of age, sex, exact discharge diagnosis-related group, mi nimum length of hospital stay equal to the interval from admission to consultation for cases, and measures of the severity of illness (nursi ng acuity score and the number of secondary diagnoses). Cases had long er lengths of hospital stays, longer intensive we unit lengths of stay s, and higher antibiotic costs than did matched controls, and if the c onsultation occurred in the last one-third of hospitalization, cases h ad shorter lengths of hospital stay and lower antibiotic costs than di d controls.