Cost-Effectiveness, Graduate Medical Education
Conditions
Keywords
efficiency, cost-awareness, hospitals, graduate medical education
Brief summary
OBJECTIVE: To test a brief intervention designed to improve the cost-effectiveness of care provided by medicine housestaff for hospitalized patients. HYPOTHESIS: A brief intervention in which medicine residents receive itemized bills for recent patients cared for by them, followed by a discussion on approaches to reducing unnecessary inpatient costs, can result in significant cost reductions without adversely affecting patient outcomes.
Detailed description
We designed a brief educational intervention with two primary objectives: 1) to increase awareness among residents about how their decisions impact the costs of inpatient medical care; and 2) to improve the cost-effectiveness of care provided by residents without adversely affecting patient outcomes. We hypothesized that a brief intervention in which residents receive bills for patients they recently cared for, followed by a discussion on approaches to reducing unnecessary inpatient costs, would reduce costs without adversely affecting patient outcomes.
Interventions
BEHAVIORALEducational Intervention
45-minute teaching session on healthcare costs, in which each resident reviewed an itemized hospital bill for a patient he/she had cared for, followed by an open-ended discussion about reducing unnecessary costs.
Sponsors
Partners Center of Expertise in Quality and Patient Safety
Brigham and Women's Hospital
Study design
Allocation
RANDOMIZED
Eligibility
Sex/Gender
ALL
Inclusion criteria
* Internal Medicine Residents on Inpatient Rotations at Brigham & Women's Hospital
Exclusion criteria
* Having a team member who was in either the control group or intervention group in a prior round of this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiology Cost | 2 weeks following educational intervention | Total radiology cost per admission for 2 weeks following the educational intervention. |
| Total Cost | 2 weeks following educational intervention | Total hospital cost per admission for 2 weeks following the educational intervention. |
| Lab Cost | 2 weeks following educational intervention | Total lab cost per admission for 2 weeks following the educational intervention. |
| Pharmacy Cost | 2 weeks following educational intervention | Total pharmacy cost per admission for 2 weeks following the educational intervention. |
Secondary
| Measure | Time frame |
|---|---|
| length of stay | 2 weeks after educational intervention |
| admission to an intensive care unit (ICU) | 2 weeks after educational intervention |
| 30-day readmission | within 30 days after end of study period |
| 30-day mortality | within 30 days after end of study period |
Countries
United States
Outcome results
None listed