The Relationship of House Staff Experience to the Cost and Quality of Inpatient Care

摘要: The inexperience of house staff has been offered as one explanation for the increased cost care at teaching hospitals, but conclusive evidence this lacking. We studied relationship experience to and quality inpatient in a large series internal medicine patients hospital. defined by month academic year during which patient received care. Our measures were length hospital stay total charges, while our deaths, readmissions, nursing home placement. Multiple linear regression analysis on 21 679 discharges revealed increasing be associated with significant decline (95% confidence interval b, — 0.006 0.066 days per discharge experience) charges 0.002 0.017 log dollars experience). These findings constitute an estimated average 0.43 $370 over year. Logistic found no or suggest that process training inexperienced physicians may represent important source inefficiency hospitals struggling competitive environment. (JAMA. 1990;263:953-957)