A teaching service could be effective in reducing resource use when treating patients with acute exacerbation of COPD, according to research published in the Journal of Evaluation in Clinical Practice.
Khalid Abusaada, MD, from Florida Hospital in Orlando, and colleagues conducted a retrospective cohort study involving patients admitted for a primary diagnosis of COPD exacerbation to examine the impact of an internal medicine teaching service versus a nonteaching service at a large community teaching hospital. The authors measured risk-adjusted length of stay (LOS), cost of hospitalization, 30-day readmissions, and mortality rate. Data were extracted for 1,419 patients: 306 in the teaching group and 1,113 in the nonteaching group.
The researchers found that the teaching group had significantly lower risk-adjusted cost and LOS than the nonteaching group (observed/expected cost, 0.66 versus 1.06; observed/expected LOS, 0.93 versus 1.69). Risk-adjusted mortality and readmissions did not differ significantly between the groups. The teaching group had significantly lower use of consults, with 73 and 31 percent of patients in the teaching and nonteaching groups having no consults, respectively. After adjustment for other variables, the teaching service correlated with significantly decreased use of consults (odds ratio, 0.17).
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