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Primary

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care physicians topical antibiotics and birth control lotion reviews</blockquote> primarily because of earlier recognition of stability

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and more rapid conversion from intravenous to oral antibiotics. Comparison of processes and outcomes of pneumonia care between hospitalists and community-based primary care physicians.OBJECTIVE. We retrospectively revie the medical charts of 455 patients hospitalized with pneumonia at a community-based tertiary care center

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between , and. Primary care physicians were more likely to prescribe clindamycin and ceftazidime, and they requested infectious disease consultations more often. No significant differences were noted in adjusted inpatient mortality or the appropriateness of initial antibiotics used. All patients were cared for by either a full-time hospitalist

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or a primary care physician. Other than earlier

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switch to oral antibiotics, less use of clindamycin and ceftazidime, and fewer infectious disease consultations, hospitalists' processes of care

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were similar to those of primary care physicians. The mean adjusted

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LOS was 5.6 days for hospitalists and 6.5 days for primary care physicians. Differences in hospital

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readmission rates at 15 and 30 days were not statistically significant in combined or risk-stratified analyses. A difference in door-to-needle time of 0.9 hour favoring primary care physicians did not contribute to LOS. To compare medical care provided by hospitalists and primary care physicians to patients with community-acquired pneumonia in order to identify specific practices that might explain the improved efficiency of care provided by hospitalists.

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Exclusion criteria included human immunodeficiency virus infection, lung cancer, active tuberculosis, hospitalization within 7 days, length of stay (LOS) more than 14 days, and requirement of mechanical ventilation. Data collected included patient insurance status, variables

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to calculate each patient's Pneumonia Severity Index score, initial antibiotic selection, door-to-needle time, time to patient stability for switch to oral antibiotics, time to actual switch, unstable variables at discharge, and subspecialty consultation rate. The mean time to stability was 3.2 days for hospitalists

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and 3.3 days for primary care physicians, and the mean time from stability to actual switch from intravenous to oral antibiotics was 1.6 days and 23 days, respectively (P .003). Primary care physician patients were older, and this group had a higher proportion of the highest-risk patients.

Outcomes measured via administrative database were mortality, LOS, costs, and readmission rate. Similarly adjusted costs were $594 less per patient treated by hospitalists. However, patients seen by hospitalists were discharged with an unstable clinical variable more often.