To measure the impact of an otolaryngology hospitalist service on patient care and physician collaboration at UCSF Medical Center, Dr. Matthew S. Russell and his colleagues quantified their interventions between mid-2009 and December 2011.
During this period, otolaryngology hospitalists consulted on 375 new inpatients and generated 951 patient encounters. They most often evaluated general/pediatric cases (39%), laryngology concerns (29%), and rhinology issues (19%), according to a subanalysis of the first 18 months.
Respiratory failure was the most common specific diagnosis (12%) associated with a consult. They also consulted on patients with sinusitis (11%), stridor (11%), and dysphonia (8%), according to analysis of a billing database, including ICD-9 and CPT codes.
Otolaryngology hospitalists provided a total of 384 procedural or surgical interventions during the study period. Endoscopic sinonasal interventions were the most common procedure (122 codes), followed by transnasal flexible laryngoscopy (94 codes), and operative endoscopy (71 codes). A tally listing 19 specific codes was included in Dr. Russell’s poster presentation at the meeting.
Use of an administrative database is a potential limitation of the study that likely underestimated the number of otolaryngology hospitalist interventions, Dr. Russell said. "I was a bit surprised by the volume of consultations and procedures in the consortium model data, both of which seemed low compared to my experience this year as a sole service provider. I suspect this is a limitation of how the data was collected for administrative review rather than a true phenomenon."
An online search revealed no comparable otolaryngology service. "To our knowledge, ours is the first full-time otolaryngology hospitalist model in the United States," the investigators noted.