TY - JOUR
T1 - Community pediatric hospitalists providing care in the emergency department
T2 - An analysis of physician productivity and financial performance
AU - Dudas, Robert A.
AU - Monroe, David
AU - McColligan Borger, Melissa
PY - 2011/11/1
Y1 - 2011/11/1
N2 - Objectives: Community hospital pediatric inpatient programs are being threatened by current financial and demographic trends. We describe a model of care and report on the financial implications associated with combining emergency department (ED) and inpatient care of pediatric patients. We determine whether this type of model could generate sufficient revenue to support physician salaries for continuous in-house coverage in community hospitals. Methods: Financial productivity and selected performance indicators were obtained from a retrospective review of registration and billing records. Data were obtained from 2 community-based pediatric hospitalist programs, which are part of a single health system and included care delivered in the ED and inpatient settings during a 1-year period from July 1, 2008, to July 1, 2009. Results: Together, the combined programs were able to generate 6079 total relative value units and collections of $244,828 annually per full-time equivalent (FTE). Salary, benefits, and practice expenses totaled $235,674 per FTE. Thus, combined daily revenues exceeded expenses and provided 104% of physician salary, benefits, and practice expenses. However, 1 program generated a net profit of $329,715 ($40,706 per FTE), whereas the other recorded a loss of $207,969 ($39,994 per FTE). Emergency department throughput times and left-without-being-seen rates at both programs were comparable to national benchmarks. Conclusions: Incorporating ED care into a pediatric hospitalist program can be an effective strategy to maintain the financial viability of pediatric services at community hospitals with low inpatient volumes that seek to provide 24-hour pediatric staffing.
AB - Objectives: Community hospital pediatric inpatient programs are being threatened by current financial and demographic trends. We describe a model of care and report on the financial implications associated with combining emergency department (ED) and inpatient care of pediatric patients. We determine whether this type of model could generate sufficient revenue to support physician salaries for continuous in-house coverage in community hospitals. Methods: Financial productivity and selected performance indicators were obtained from a retrospective review of registration and billing records. Data were obtained from 2 community-based pediatric hospitalist programs, which are part of a single health system and included care delivered in the ED and inpatient settings during a 1-year period from July 1, 2008, to July 1, 2009. Results: Together, the combined programs were able to generate 6079 total relative value units and collections of $244,828 annually per full-time equivalent (FTE). Salary, benefits, and practice expenses totaled $235,674 per FTE. Thus, combined daily revenues exceeded expenses and provided 104% of physician salary, benefits, and practice expenses. However, 1 program generated a net profit of $329,715 ($40,706 per FTE), whereas the other recorded a loss of $207,969 ($39,994 per FTE). Emergency department throughput times and left-without-being-seen rates at both programs were comparable to national benchmarks. Conclusions: Incorporating ED care into a pediatric hospitalist program can be an effective strategy to maintain the financial viability of pediatric services at community hospitals with low inpatient volumes that seek to provide 24-hour pediatric staffing.
KW - combined pediatric unit
KW - community hospital
KW - hospitalist
KW - resource-based relative value units
UR - http://www.scopus.com/inward/record.url?scp=80955123668&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80955123668&partnerID=8YFLogxK
U2 - 10.1097/PEC.0b013e31823606f5
DO - 10.1097/PEC.0b013e31823606f5
M3 - Article
C2 - 22068082
AN - SCOPUS:80955123668
SN - 0749-5161
VL - 27
SP - 1099
EP - 1103
JO - Pediatric emergency care
JF - Pediatric emergency care
IS - 11
ER -