Early Infectious Diseases Specialty Intervention Is Associated with Shorter Hospital Stays and Lower Readmission Rates: A Retrospective Cohort Study

Steven Schmitt, Ann T. MacIntyre, Susan C. Bleasdale, J. Trees Ritter, Sandra B. Nelson, Elie F. Berbari, Steven D. Burdette, Angela L Hewlett, Matthew Miles, Philip A. Robinson, Javeed Siddiqui, Robin Trotman, Lawrence Martinelli, Gary Zeitlin, Andrés Rodriguez, Mark W. Smith, Daniel P. McQuillen

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background. Intervention by infectious diseases (ID) physicians improves outcomes for inpatients in Medicare, but patients with other insurance types could fare differently. We assessed whether ID involvement leads to better outcomes among privately insured patients under age 65 years hospitalized with common infections. Methods. We performed a retrospective analysis of administrative claims data from community hospital and postdischarge ambulatory care. Patients were privately insured individuals less than 65 years old with an acute-care stay in 2014 for selected infections, classed as having early (by day 3) or late (after day 3) ID intervention, or none. Key outcomes were mortality, cost, length of the index stay, readmission rate, mortality, and total cost of care over the first 30 days after discharge. Results. Patients managed with early ID involvement had shorter length of stay, lower spending, and lower mortality in the index stay than those patients managed without ID involvement. Relative to late, early ID involvement was associated with shorter length of stay and lower cost. Individuals with early ID intervention during hospitalization had fewer readmissions and lower healthcare payments after discharge. Relative to late, those with early ID intervention experienced lower readmission, lower spending, and lower mortality. Conclusions. Among privately insured patients less than 65 years old, treated in a hospital, early intervention with an ID physician was associated with lower mortality rate and shorter length of stay. Patients who received early ID intervention during their hospital stay were less likely to be readmitted after discharge and had lower total healthcare spending.

Original languageEnglish (US)
Pages (from-to)239-246
Number of pages8
JournalClinical Infectious Diseases
Volume68
Issue number2
DOIs
StatePublished - Jan 7 2019

Fingerprint

Infectious Disease Medicine
Communicable Diseases
Length of Stay
Cohort Studies
Retrospective Studies
Mortality
Costs and Cost Analysis
Insurance Claim Review
Delivery of Health Care
Physicians
Community Hospital
Ambulatory Care
Medicare
Infection
Insurance
Inpatients

Keywords

  • Costs
  • Infectious diseases
  • Mortality
  • Patient outcomes
  • Utilization

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Schmitt, S., MacIntyre, A. T., Bleasdale, S. C., Ritter, J. T., Nelson, S. B., Berbari, E. F., ... McQuillen, D. P. (2019). Early Infectious Diseases Specialty Intervention Is Associated with Shorter Hospital Stays and Lower Readmission Rates: A Retrospective Cohort Study. Clinical Infectious Diseases, 68(2), 239-246. https://doi.org/10.1093/cid/ciy494

Early Infectious Diseases Specialty Intervention Is Associated with Shorter Hospital Stays and Lower Readmission Rates : A Retrospective Cohort Study. / Schmitt, Steven; MacIntyre, Ann T.; Bleasdale, Susan C.; Ritter, J. Trees; Nelson, Sandra B.; Berbari, Elie F.; Burdette, Steven D.; Hewlett, Angela L; Miles, Matthew; Robinson, Philip A.; Siddiqui, Javeed; Trotman, Robin; Martinelli, Lawrence; Zeitlin, Gary; Rodriguez, Andrés; Smith, Mark W.; McQuillen, Daniel P.

In: Clinical Infectious Diseases, Vol. 68, No. 2, 07.01.2019, p. 239-246.

Research output: Contribution to journalArticle

Schmitt, S, MacIntyre, AT, Bleasdale, SC, Ritter, JT, Nelson, SB, Berbari, EF, Burdette, SD, Hewlett, AL, Miles, M, Robinson, PA, Siddiqui, J, Trotman, R, Martinelli, L, Zeitlin, G, Rodriguez, A, Smith, MW & McQuillen, DP 2019, 'Early Infectious Diseases Specialty Intervention Is Associated with Shorter Hospital Stays and Lower Readmission Rates: A Retrospective Cohort Study', Clinical Infectious Diseases, vol. 68, no. 2, pp. 239-246. https://doi.org/10.1093/cid/ciy494
Schmitt, Steven ; MacIntyre, Ann T. ; Bleasdale, Susan C. ; Ritter, J. Trees ; Nelson, Sandra B. ; Berbari, Elie F. ; Burdette, Steven D. ; Hewlett, Angela L ; Miles, Matthew ; Robinson, Philip A. ; Siddiqui, Javeed ; Trotman, Robin ; Martinelli, Lawrence ; Zeitlin, Gary ; Rodriguez, Andrés ; Smith, Mark W. ; McQuillen, Daniel P. / Early Infectious Diseases Specialty Intervention Is Associated with Shorter Hospital Stays and Lower Readmission Rates : A Retrospective Cohort Study. In: Clinical Infectious Diseases. 2019 ; Vol. 68, No. 2. pp. 239-246.
@article{8cafa01b7ecd4972bc64cfe2c897f4bf,
title = "Early Infectious Diseases Specialty Intervention Is Associated with Shorter Hospital Stays and Lower Readmission Rates: A Retrospective Cohort Study",
abstract = "Background. Intervention by infectious diseases (ID) physicians improves outcomes for inpatients in Medicare, but patients with other insurance types could fare differently. We assessed whether ID involvement leads to better outcomes among privately insured patients under age 65 years hospitalized with common infections. Methods. We performed a retrospective analysis of administrative claims data from community hospital and postdischarge ambulatory care. Patients were privately insured individuals less than 65 years old with an acute-care stay in 2014 for selected infections, classed as having early (by day 3) or late (after day 3) ID intervention, or none. Key outcomes were mortality, cost, length of the index stay, readmission rate, mortality, and total cost of care over the first 30 days after discharge. Results. Patients managed with early ID involvement had shorter length of stay, lower spending, and lower mortality in the index stay than those patients managed without ID involvement. Relative to late, early ID involvement was associated with shorter length of stay and lower cost. Individuals with early ID intervention during hospitalization had fewer readmissions and lower healthcare payments after discharge. Relative to late, those with early ID intervention experienced lower readmission, lower spending, and lower mortality. Conclusions. Among privately insured patients less than 65 years old, treated in a hospital, early intervention with an ID physician was associated with lower mortality rate and shorter length of stay. Patients who received early ID intervention during their hospital stay were less likely to be readmitted after discharge and had lower total healthcare spending.",
keywords = "Costs, Infectious diseases, Mortality, Patient outcomes, Utilization",
author = "Steven Schmitt and MacIntyre, {Ann T.} and Bleasdale, {Susan C.} and Ritter, {J. Trees} and Nelson, {Sandra B.} and Berbari, {Elie F.} and Burdette, {Steven D.} and Hewlett, {Angela L} and Matthew Miles and Robinson, {Philip A.} and Javeed Siddiqui and Robin Trotman and Lawrence Martinelli and Gary Zeitlin and Andr{\'e}s Rodriguez and Smith, {Mark W.} and McQuillen, {Daniel P.}",
year = "2019",
month = "1",
day = "7",
doi = "10.1093/cid/ciy494",
language = "English (US)",
volume = "68",
pages = "239--246",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Early Infectious Diseases Specialty Intervention Is Associated with Shorter Hospital Stays and Lower Readmission Rates

T2 - A Retrospective Cohort Study

AU - Schmitt, Steven

AU - MacIntyre, Ann T.

AU - Bleasdale, Susan C.

AU - Ritter, J. Trees

AU - Nelson, Sandra B.

AU - Berbari, Elie F.

AU - Burdette, Steven D.

AU - Hewlett, Angela L

AU - Miles, Matthew

AU - Robinson, Philip A.

AU - Siddiqui, Javeed

AU - Trotman, Robin

AU - Martinelli, Lawrence

AU - Zeitlin, Gary

AU - Rodriguez, Andrés

AU - Smith, Mark W.

AU - McQuillen, Daniel P.

PY - 2019/1/7

Y1 - 2019/1/7

N2 - Background. Intervention by infectious diseases (ID) physicians improves outcomes for inpatients in Medicare, but patients with other insurance types could fare differently. We assessed whether ID involvement leads to better outcomes among privately insured patients under age 65 years hospitalized with common infections. Methods. We performed a retrospective analysis of administrative claims data from community hospital and postdischarge ambulatory care. Patients were privately insured individuals less than 65 years old with an acute-care stay in 2014 for selected infections, classed as having early (by day 3) or late (after day 3) ID intervention, or none. Key outcomes were mortality, cost, length of the index stay, readmission rate, mortality, and total cost of care over the first 30 days after discharge. Results. Patients managed with early ID involvement had shorter length of stay, lower spending, and lower mortality in the index stay than those patients managed without ID involvement. Relative to late, early ID involvement was associated with shorter length of stay and lower cost. Individuals with early ID intervention during hospitalization had fewer readmissions and lower healthcare payments after discharge. Relative to late, those with early ID intervention experienced lower readmission, lower spending, and lower mortality. Conclusions. Among privately insured patients less than 65 years old, treated in a hospital, early intervention with an ID physician was associated with lower mortality rate and shorter length of stay. Patients who received early ID intervention during their hospital stay were less likely to be readmitted after discharge and had lower total healthcare spending.

AB - Background. Intervention by infectious diseases (ID) physicians improves outcomes for inpatients in Medicare, but patients with other insurance types could fare differently. We assessed whether ID involvement leads to better outcomes among privately insured patients under age 65 years hospitalized with common infections. Methods. We performed a retrospective analysis of administrative claims data from community hospital and postdischarge ambulatory care. Patients were privately insured individuals less than 65 years old with an acute-care stay in 2014 for selected infections, classed as having early (by day 3) or late (after day 3) ID intervention, or none. Key outcomes were mortality, cost, length of the index stay, readmission rate, mortality, and total cost of care over the first 30 days after discharge. Results. Patients managed with early ID involvement had shorter length of stay, lower spending, and lower mortality in the index stay than those patients managed without ID involvement. Relative to late, early ID involvement was associated with shorter length of stay and lower cost. Individuals with early ID intervention during hospitalization had fewer readmissions and lower healthcare payments after discharge. Relative to late, those with early ID intervention experienced lower readmission, lower spending, and lower mortality. Conclusions. Among privately insured patients less than 65 years old, treated in a hospital, early intervention with an ID physician was associated with lower mortality rate and shorter length of stay. Patients who received early ID intervention during their hospital stay were less likely to be readmitted after discharge and had lower total healthcare spending.

KW - Costs

KW - Infectious diseases

KW - Mortality

KW - Patient outcomes

KW - Utilization

UR - http://www.scopus.com/inward/record.url?scp=85059497491&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059497491&partnerID=8YFLogxK

U2 - 10.1093/cid/ciy494

DO - 10.1093/cid/ciy494

M3 - Article

C2 - 29901775

AN - SCOPUS:85059497491

VL - 68

SP - 239

EP - 246

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 2

ER -