Purpose. To examine the associations between (1) the economic indicato
rs of hospital costs, charges, and length of stay (LOS) for inpatient
cases and (2) the use of MEDLINE searches for such cases. Method. An o
utcome-based, objective, prospective study with an economic evaluation
was conducted from September 1989 to September 1990 at three metropol
itan Detroit teaching hospitals representing both allopathic and osteo
pathic care. The study consisted of (1) 192 test cases, derived from a
consecutive sample of inpatients of all ages for whom MEDLINE searche
s were requested at the participating medical libraries, and (2) 10,40
9 control cases, which were of the same diagnosis-related groups (DRGs
) as the test cases but did not involve identified MEDLINE searches. S
tatistical analysis included the use of multivariate analyses of varia
nce and correlation coefficients. Comparisons of cases were made on ca
se-by-case and DRG bases regarding total patient costs, charges, and l
engths of stay for cases with or without MEDLINE searches. Results. Th
e test cases were found to have a higher severity of illness. Among te
st cases, statistically significant relationships existed between (1)
hospital expenses and LOS and (2) hospital expenses and the timing of
the search during hospitalization when controlling for LOS. When cases
were matched for DRG and LOS, the cases with early searches (i.e., co
nducted during the first half of hospitalization) had significantly lo
wer expenses. Conclusion. Of the test-case patients (for whom MEDLINE
searches were conducted during hospitalization), those whose searches
were conducted earlier had statistically significantly lower costs, ch
arges, and lengths of stay than those whose searches were conducted la
ter.