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Do consultants differ? Inferences drawn from hospital in-patient enquiry (HIPE) discharge coding at an Irish teaching hospital.
Postgrad Med J. 2005 May; 81(955):327-32.PM

Abstract

OBJECTIVE

To find out if there was a difference between hospital consultants, all trained in acute general medicine, in length of stay (LOS), re-admission rates, resource utilisation, and diagnostic coding, among patients admitted as emergencies to St James' Hospital (SJH) Dublin.

METHODS

A retrospective analysis was performed of data on discharges from hospital, recorded in the hospital in-patient enquiry (HIPE) system, relating to 9204 episodes among 6968 emergency medical patients admitted to SJH between 1 January 2002 and 31 October 2003. For comparative analysis, four physician groups were defined consisting of gastroenterology (GI, n = 4), respiratory (n = 3), general internal medicine (GIM, n = 2), or specialty (n = 5).

RESULTS

GIM consultants had the shortest LOS (median 5 days); GIM and respiratory consultants were less likely to have long stay patients (> 30 days, p<0.0001). Patients re-admitted under the same consultant had a longer LOS than those re-admitted under a different consultant (p<0.0001). Endoscopy and GI radiology investigations were used most by GI consultants, computed tomography of the thorax by respiratory, ECHO by respiratory and specialty, and computed tomography of brain by GIM and specialty consultants. GI diagnostic codings were more frequent with GI consultants (p<0.0001), respiratory diagnoses and malignancy with respiratory (p<0.0001 for both), diabetes and hypertension with specialty (p = 0.0017), and heart failure more with GIM consultants (p = 0.001).

CONCLUSIONS

This study found that the HIPE database was very powerful in predicting differences between hospital consultants in LOS, re-admission rates, resource utilisation, and disease coding. It would be of interest to examine the extent to which protocols and guidelines could reduce such variations.

Authors+Show Affiliations

Division of Internal Medicine St James' Hospital, Dublin, Ireland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15879047

Citation

Moloney, E D., et al. "Do Consultants Differ? Inferences Drawn From Hospital In-patient Enquiry (HIPE) Discharge Coding at an Irish Teaching Hospital." Postgraduate Medical Journal, vol. 81, no. 955, 2005, pp. 327-32.
Moloney ED, Smith D, Bennett K, et al. Do consultants differ? Inferences drawn from hospital in-patient enquiry (HIPE) discharge coding at an Irish teaching hospital. Postgrad Med J. 2005;81(955):327-32.
Moloney, E. D., Smith, D., Bennett, K., O'Riordan, D., & Silke, B. (2005). Do consultants differ? Inferences drawn from hospital in-patient enquiry (HIPE) discharge coding at an Irish teaching hospital. Postgraduate Medical Journal, 81(955), 327-32.
Moloney ED, et al. Do Consultants Differ? Inferences Drawn From Hospital In-patient Enquiry (HIPE) Discharge Coding at an Irish Teaching Hospital. Postgrad Med J. 2005;81(955):327-32. PubMed PMID: 15879047.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do consultants differ? Inferences drawn from hospital in-patient enquiry (HIPE) discharge coding at an Irish teaching hospital. AU - Moloney,E D, AU - Smith,D, AU - Bennett,K, AU - O'Riordan,D, AU - Silke,B, PY - 2005/5/10/pubmed PY - 2005/9/9/medline PY - 2005/5/10/entrez SP - 327 EP - 32 JF - Postgraduate medical journal JO - Postgrad Med J VL - 81 IS - 955 N2 - OBJECTIVE: To find out if there was a difference between hospital consultants, all trained in acute general medicine, in length of stay (LOS), re-admission rates, resource utilisation, and diagnostic coding, among patients admitted as emergencies to St James' Hospital (SJH) Dublin. METHODS: A retrospective analysis was performed of data on discharges from hospital, recorded in the hospital in-patient enquiry (HIPE) system, relating to 9204 episodes among 6968 emergency medical patients admitted to SJH between 1 January 2002 and 31 October 2003. For comparative analysis, four physician groups were defined consisting of gastroenterology (GI, n = 4), respiratory (n = 3), general internal medicine (GIM, n = 2), or specialty (n = 5). RESULTS: GIM consultants had the shortest LOS (median 5 days); GIM and respiratory consultants were less likely to have long stay patients (> 30 days, p<0.0001). Patients re-admitted under the same consultant had a longer LOS than those re-admitted under a different consultant (p<0.0001). Endoscopy and GI radiology investigations were used most by GI consultants, computed tomography of the thorax by respiratory, ECHO by respiratory and specialty, and computed tomography of brain by GIM and specialty consultants. GI diagnostic codings were more frequent with GI consultants (p<0.0001), respiratory diagnoses and malignancy with respiratory (p<0.0001 for both), diabetes and hypertension with specialty (p = 0.0017), and heart failure more with GIM consultants (p = 0.001). CONCLUSIONS: This study found that the HIPE database was very powerful in predicting differences between hospital consultants in LOS, re-admission rates, resource utilisation, and disease coding. It would be of interest to examine the extent to which protocols and guidelines could reduce such variations. SN - 0032-5473 UR - https://www.unboundmedicine.com/medline/citation/15879047/Do_consultants_differ_Inferences_drawn_from_hospital_in_patient_enquiry__HIPE__discharge_coding_at_an_Irish_teaching_hospital_ L2 - https://pmj.bmj.com/lookup/pmidlookup?view=long&amp;pmid=15879047 DB - PRIME DP - Unbound Medicine ER -