University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Hospital Medicine


Dr. Nancy Reid


Purpose: The purpose of this article is to review the utilization of Advance Practice Providers (APP) in hospital medicine and how their utilization can increase productivity and cost effectiveness for hospital medicine programs.

Method: A PubMed literature search was conducted with the search terms hospital medicine programs, advanced practice providers, physician assistants, and cost effectiveness. The search was narrowed to articles published within the last five years. Ten relevant articles were retrieved and serve as the basis for this article.

Results: There is little to no evidence-based research to demonstrate the cost effectiveness of inclusion of advance practice providers in hospital medicine programs.

Conclusion: Hospitals have implemented the use of hospitalist (a dedicated in-patient physician working exclusively in a hospital) programs to better manage inpatient care while reducing the overhead cost of caring for patients such as increased lengths of stay and appropriate billing. Hospitalist programs work very well, however, physicians tend to get burned out. Advanced Practice Providers (APP) have eased the workload and allow for improved quality of care by increasing the number of patients that can safely be seen and treated in an acute inpatient setting safely. Most of these patients are being seen in shared visits with the physician and APP. The hospitals are only being paid for one provider during these visits—the physician—yet they pay both the physician and the APP. By allowing APPs to see patients independently and bill as such, the hospital could potentially save more money and effectively profit at a greater margin.


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