Association of Variation in Consultant Use Among Hospitalist Physicians With Outcomes Among Medicare Beneficiaries

Key Points Question Are hospitalized Medicare beneficiaries who are exposed to higher rates of specialty consultation associated with outcomes such as greater resource use, length of stay, readmissions, and mortality? Findings In this cohort study of 711 654 inpatient medical admissions, hospitalists who used specialty consultation more than their colleagues at the same institution used more resources without a difference in patient mortality. Compared with patients treated by other hospitalists, the patients of high-consulting hospitalists had longer lengths of stay, were less likely to go home, and were more likely to see a specialist within 90 days after discharge, but there was no significant difference in their mortality at 30 days or their likelihood of all-cause readmission. Meaning A decrease in the frequency of specialty consultation may be an opportunity for hospitals to reduce complexity and costs in patient care without adversely affecting patients.