The survey analysis of productivity breaks this performance measure into two categories:
- Inputs: The hours worked by hospitalists. Three categories of hours worked are analyzed in this chapter: inpatient hours worked, non-patient hours worked, and on-call hours worked. Please note, the analysis excludes outpatient hours worked because only 15% of the survey respondents reported any outpatient hours.
- Outputs: The work completed by hospitalists. This includes charges generated, collections generated, patient encounters, patient admissions and consults, and relative value units (RVUs) of work completed. These measures are analyzed in chapter 5 (to be published in the March/April Hospitalist issue.
Overall, surveyed physician hospitalists worked a median of 2,100 inpatient hours per year. They had a median of 50 non-patient hours per year (about one per week) and worked a median of 600 on-call hours per year. The analyses below look at productivity inputs by region, employment model, specialty/provider type, and compensation model.
- Academic hospitalists work the least amount of inpatient hours (1,700 vs. an overall median of 2,100). However, they work significantly more non‑patient hours (150 vs. 50), probably because of their teaching responsibilities.
- Hospitalists that work for hospitalist-only groups work more inpatient hours than the overall median: multistate hospitalist only groups are 14% higher (2,400 vs. 2,100), while local hospitalist-only groups are 5% higher (2,210 vs. 2,100).
- Regarding on-call hours, hospitalists that work for hospital-based groups have a median of zero. This is probably because only 27% of hospital-based groups have call-based staffing, significantly less than other employment categories (see Chapter 1). This also is probably the explanation for the median of zero for eastern hospitalists, as that region has a high proportion of hospital-based groups.
- Adult medicine hospitalists work 24% more inpatient hours than pediatric hospitalists (2,111 vs. 1,700). Conversely, pediatric hospitalists have four times as many non-patient hours (200 vs. 50). This is likely explained by the fact that pediatricians are twice as likely to work in academia (see chapter 1).
- Non-physician hospitalists have a median of 1,900 inpatient hours and a median of only 10 non-patient hours
- There is a strong relationship between compensation model and hours worked. Hospitalists that work under a 100% productivity model have a median number of inpatient hours that is 30% more than those that work in a 100% salary model (2,500 vs. 1,930). Hospitalists that work in a mixed model fall in the middle (2,184).
- There is minimal difference in the non-patient hours worked among the three categories (approximately 50). However, 100% productivity-model hospitalists have a median number of on-call hours, which is almost 3 times greater than that of 100% salary-based hospitalists (1,250 vs. 416). Again, mixed-model hospitalists fall in the middle (700).