Comparison of specialist and generalist care

C. M. Horwood, P. Hakendorf, C. H. Thompson

Research output: Contribution to journalArticle

Abstract

Objective. The choice of whether to admit under a specialist or a generalist unit is often made with neither clear rationale nor understanding of its consequences. The present study compared the characteristics and outcomes of patients admitted with community-acquired pneumonia to either a general medicine or respiratory unit. Methods. This study was a retrospective cross-sectional study using data from public hospitals in Adelaide, South Australia. Over 5 years there were 9775 overnight, unplanned appropriate adult admissions. Patient length of hospital stay, inpatient mortality rate and 30-day unplanned readmission rate were calculated, with and without adjustment for patient age and comorbidity burden. Results. Over 80% of these patients were cared for by a general medicine unit rather than a specialist unit. Patients admitted to a general medicine unit were, on average, 4 years older than those admitted to a respiratory unit. Comorbidity burdens were similar between units at the same hospital. Length of in-patient stay was >1 day shorter for those admitted to a general medicine unit, without significant compromise in mortality or readmission rates. Between each hospital, general medicine units showed a range of mortality rates and length of hospital stay, for which there was no obvious explanation. Conclusions. Compared with speciality care, general medicine units can safely and efficiently care for patients presenting to hospital with community-acquired pneumonia.

Original languageEnglish
Pages (from-to)579-583
Number of pages5
JournalAustralian Health Review
Volume42
Issue number5
DOIs
Publication statusPublished - 2018
Externally publishedYes

Keywords

  • community acquired pneumonia
  • mortality
  • relative stay index

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