The use of in-hospital physician services for acute myocardial infarction. Changes in volume and complexity over time
E. Sawitz, J. A. Showstack, J. Chow and S. A. Schroeder
Institute for Health Policy Studies, San Francisco, CA 94143-0936.
Changes between 1972 and 1982 in the use of in-hospital services were
studied for 164 patients admitted with acute myocardial infarction.
Resource use was measured in constant 1982 dollars adjusted for differences
in clinical severity of the patients. Although average length of stay
decreased by almost 40% during this period, the number of physician
services doubled and total physician costs increased almost threefold. The
increase in physician costs was due primarily to the use of complex
diagnostic technologies and to the provision of coronary artery bypass
graft surgery. The results of this study suggest that as hospital costs are
constrained by prospective payment, physician costs may continue to rise as
new diagnostic and therapeutic services are introduced into practice and as
more care is shifted to the outpatient setting.
