Community pediatric hospitalists providing care in the emergency department: An analysis of physician productivity and financial performance

Robert A Dudas, David J Monroe, Melissa McColligan Borger

Research output: Contribution to journalArticle

Abstract

Objectives: Community hospital pediatric inpatient programs are being threatened by current financial and demographic trends. We describe a model of care and report on the financial implications associated with combining emergency department (ED) and inpatient care of pediatric patients. We determine whether this type of model could generate sufficient revenue to support physician salaries for continuous in-house coverage in community hospitals. Methods: Financial productivity and selected performance indicators were obtained from a retrospective review of registration and billing records. Data were obtained from 2 community-based pediatric hospitalist programs, which are part of a single health system and included care delivered in the ED and inpatient settings during a 1-year period from July 1, 2008, to July 1, 2009. Results: Together, the combined programs were able to generate 6079 total relative value units and collections of $244,828 annually per full-time equivalent (FTE). Salary, benefits, and practice expenses totaled $235,674 per FTE. Thus, combined daily revenues exceeded expenses and provided 104% of physician salary, benefits, and practice expenses. However, 1 program generated a net profit of $329,715 ($40,706 per FTE), whereas the other recorded a loss of $207,969 ($39,994 per FTE). Emergency department throughput times and left-without-being-seen rates at both programs were comparable to national benchmarks. Conclusions: Incorporating ED care into a pediatric hospitalist program can be an effective strategy to maintain the financial viability of pediatric services at community hospitals with low inpatient volumes that seek to provide 24-hour pediatric staffing.

Original languageEnglish (US)
Pages (from-to)1099-1103
Number of pages5
JournalPediatric Emergency Care
Volume27
Issue number11
DOIs
StatePublished - Nov 2011

Fingerprint

Hospitalists
Hospital Emergency Service
Pediatrics
Physicians
Inpatients
Salaries and Fringe Benefits
Community Hospital
Benchmarking
Emergency Medical Services
Patient Care
Demography
Health

Keywords

  • combined pediatric unit
  • community hospital
  • hospitalist
  • resource-based relative value units

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

@article{16f741ad03cd4a799841b14adfe85e58,
title = "Community pediatric hospitalists providing care in the emergency department: An analysis of physician productivity and financial performance",
abstract = "Objectives: Community hospital pediatric inpatient programs are being threatened by current financial and demographic trends. We describe a model of care and report on the financial implications associated with combining emergency department (ED) and inpatient care of pediatric patients. We determine whether this type of model could generate sufficient revenue to support physician salaries for continuous in-house coverage in community hospitals. Methods: Financial productivity and selected performance indicators were obtained from a retrospective review of registration and billing records. Data were obtained from 2 community-based pediatric hospitalist programs, which are part of a single health system and included care delivered in the ED and inpatient settings during a 1-year period from July 1, 2008, to July 1, 2009. Results: Together, the combined programs were able to generate 6079 total relative value units and collections of $244,828 annually per full-time equivalent (FTE). Salary, benefits, and practice expenses totaled $235,674 per FTE. Thus, combined daily revenues exceeded expenses and provided 104{\%} of physician salary, benefits, and practice expenses. However, 1 program generated a net profit of $329,715 ($40,706 per FTE), whereas the other recorded a loss of $207,969 ($39,994 per FTE). Emergency department throughput times and left-without-being-seen rates at both programs were comparable to national benchmarks. Conclusions: Incorporating ED care into a pediatric hospitalist program can be an effective strategy to maintain the financial viability of pediatric services at community hospitals with low inpatient volumes that seek to provide 24-hour pediatric staffing.",
keywords = "combined pediatric unit, community hospital, hospitalist, resource-based relative value units",
author = "Dudas, {Robert A} and Monroe, {David J} and {McColligan Borger}, Melissa",
year = "2011",
month = "11",
doi = "10.1097/PEC.0b013e31823606f5",
language = "English (US)",
volume = "27",
pages = "1099--1103",
journal = "Pediatric Emergency Care",
issn = "0749-5161",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - Community pediatric hospitalists providing care in the emergency department

T2 - An analysis of physician productivity and financial performance

AU - Dudas, Robert A

AU - Monroe, David J

AU - McColligan Borger, Melissa

PY - 2011/11

Y1 - 2011/11

N2 - Objectives: Community hospital pediatric inpatient programs are being threatened by current financial and demographic trends. We describe a model of care and report on the financial implications associated with combining emergency department (ED) and inpatient care of pediatric patients. We determine whether this type of model could generate sufficient revenue to support physician salaries for continuous in-house coverage in community hospitals. Methods: Financial productivity and selected performance indicators were obtained from a retrospective review of registration and billing records. Data were obtained from 2 community-based pediatric hospitalist programs, which are part of a single health system and included care delivered in the ED and inpatient settings during a 1-year period from July 1, 2008, to July 1, 2009. Results: Together, the combined programs were able to generate 6079 total relative value units and collections of $244,828 annually per full-time equivalent (FTE). Salary, benefits, and practice expenses totaled $235,674 per FTE. Thus, combined daily revenues exceeded expenses and provided 104% of physician salary, benefits, and practice expenses. However, 1 program generated a net profit of $329,715 ($40,706 per FTE), whereas the other recorded a loss of $207,969 ($39,994 per FTE). Emergency department throughput times and left-without-being-seen rates at both programs were comparable to national benchmarks. Conclusions: Incorporating ED care into a pediatric hospitalist program can be an effective strategy to maintain the financial viability of pediatric services at community hospitals with low inpatient volumes that seek to provide 24-hour pediatric staffing.

AB - Objectives: Community hospital pediatric inpatient programs are being threatened by current financial and demographic trends. We describe a model of care and report on the financial implications associated with combining emergency department (ED) and inpatient care of pediatric patients. We determine whether this type of model could generate sufficient revenue to support physician salaries for continuous in-house coverage in community hospitals. Methods: Financial productivity and selected performance indicators were obtained from a retrospective review of registration and billing records. Data were obtained from 2 community-based pediatric hospitalist programs, which are part of a single health system and included care delivered in the ED and inpatient settings during a 1-year period from July 1, 2008, to July 1, 2009. Results: Together, the combined programs were able to generate 6079 total relative value units and collections of $244,828 annually per full-time equivalent (FTE). Salary, benefits, and practice expenses totaled $235,674 per FTE. Thus, combined daily revenues exceeded expenses and provided 104% of physician salary, benefits, and practice expenses. However, 1 program generated a net profit of $329,715 ($40,706 per FTE), whereas the other recorded a loss of $207,969 ($39,994 per FTE). Emergency department throughput times and left-without-being-seen rates at both programs were comparable to national benchmarks. Conclusions: Incorporating ED care into a pediatric hospitalist program can be an effective strategy to maintain the financial viability of pediatric services at community hospitals with low inpatient volumes that seek to provide 24-hour pediatric staffing.

KW - combined pediatric unit

KW - community hospital

KW - hospitalist

KW - resource-based relative value units

UR - http://www.scopus.com/inward/record.url?scp=80955123668&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80955123668&partnerID=8YFLogxK

U2 - 10.1097/PEC.0b013e31823606f5

DO - 10.1097/PEC.0b013e31823606f5

M3 - Article

C2 - 22068082

AN - SCOPUS:80955123668

VL - 27

SP - 1099

EP - 1103

JO - Pediatric Emergency Care

JF - Pediatric Emergency Care

SN - 0749-5161

IS - 11

ER -