Impact of gastroenterology consultation on the outcomes of patients admitted to the hospital with decompensated cirrhosis

Edmund J. Bini, Elizabeth H. Weinshel, Ramon Generoso, Loay Salman, Georges Dahr, Ivan Pena-Sing, Thomas Komorowski

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Managed care has strongly discouraged generalists from referring patients to specialists in an effort to reduce the costs of health care. The aim of this study was to compare patient outcomes when generalists work together with gastroenterologists or alone in the management of patients admitted to the hospital with decompensated cirrhosis. Consecutive patients admitted to the hospital with decompensated cirrhosis over a 1-year period were identified. We compared the length of stay, cost of hospitalization, incidence of hospital readmission, and mortality for patients who did and those who did not have a gastroenterology (GI) consultation. A GI consultation was requested for 107 of the 197 patients (54.3%). Patients who had a GI consultation had a significantly shorter length of stay (5.6 ± 3.5 vs. 10.1 ± 5.8 days, P < .001) and a lower cost of hospitalization ($6,004 ± $4,994 vs. $10,006 ± $6,183, P < .001) than those patients who were managed by generalists alone. The 30-day incidence of readmission (13.3% vs. 27.8%, P = .01) and mortality (7.5% vs. 16.7%, P = .045) were significantly lower in the GI consultation group. During a median follow-up of 618 days (range, 2-970), patients who had a GI consultation during hospitalization had a significantly longer time to hospital readmission (P < .001) and improved survival (P = .02) compared with those who were managed by generalists alone. In conclusion, for patients admitted to the hospital with decompensated cirrhosis, individuals who were managed by generalists in conjunction with gastroenterologists had better outcomes than those who were managed by generalists alone.

Original languageEnglish
Pages (from-to)1089-1095
Number of pages7
JournalHepatology
Volume34
Issue number6
DOIs
StatePublished - Dec 10 2001
Externally publishedYes

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Gastroenterology
Fibrosis
Referral and Consultation
Patient Readmission
Hospitalization
Length of Stay
Costs and Cost Analysis
Incidence
Managed Care Programs
Hospital Mortality
Health Care Costs
Survival
Mortality

ASJC Scopus subject areas

  • Hepatology

Cite this

Bini, E. J., Weinshel, E. H., Generoso, R., Salman, L., Dahr, G., Pena-Sing, I., & Komorowski, T. (2001). Impact of gastroenterology consultation on the outcomes of patients admitted to the hospital with decompensated cirrhosis. Hepatology, 34(6), 1089-1095. https://doi.org/10.1053/jhep.2001.29204

Impact of gastroenterology consultation on the outcomes of patients admitted to the hospital with decompensated cirrhosis. / Bini, Edmund J.; Weinshel, Elizabeth H.; Generoso, Ramon; Salman, Loay; Dahr, Georges; Pena-Sing, Ivan; Komorowski, Thomas.

In: Hepatology, Vol. 34, No. 6, 10.12.2001, p. 1089-1095.

Research output: Contribution to journalArticle

Bini, EJ, Weinshel, EH, Generoso, R, Salman, L, Dahr, G, Pena-Sing, I & Komorowski, T 2001, 'Impact of gastroenterology consultation on the outcomes of patients admitted to the hospital with decompensated cirrhosis', Hepatology, vol. 34, no. 6, pp. 1089-1095. https://doi.org/10.1053/jhep.2001.29204
Bini, Edmund J. ; Weinshel, Elizabeth H. ; Generoso, Ramon ; Salman, Loay ; Dahr, Georges ; Pena-Sing, Ivan ; Komorowski, Thomas. / Impact of gastroenterology consultation on the outcomes of patients admitted to the hospital with decompensated cirrhosis. In: Hepatology. 2001 ; Vol. 34, No. 6. pp. 1089-1095.
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