The relationship of residents' autonomy and use of a teaching hospital's resources

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

This 1990 study examines the relationship between the degree of use of patient care resources and the degree of supervision of residents by attending physicians (as perceived by residents) at a large midwestern teaching hospital. Ratings of the degree of clinical autonomy allowed residents by 65 attending physicians–each of whom had a general internal medicine practice with a significant hospital component–were provided by 23 former internal medicine chief residents and 17 internal medicine residents who were in their third year at the time of the study. A regression model was used to test the association between hospital resource use (as shown by total hospital charges to patients and their lengths of stay) and the residents' mean ratings of the degrees of autonomy the attending physicians permitted residents, for 7,169 of these physicians' patients discharged between 1986 and 1989 in 28 diagnosis-related groups. The analysis was controlled for patients' insurance status and chronic disease comorbidities. The patients whose attending physicians were rated as allowing substantial clinical autonomy had significantly lower total charges and lengths of stay (p less than .0001). These results suggest that internal medicine residents have an inherently conservative practice style that values low-intensity workups and rapid discharge of patients.

Original languageEnglish (US)
Pages (from-to)549-552
Number of pages4
JournalAcademic Medicine
Volume66
Issue number9
StatePublished - Jan 1 1991

Fingerprint

Internal Medicine
Teaching Hospitals
autonomy
resident
Physicians
Teaching
resources
Length of Stay
physician
medicine
Hospital Charges
Insurance Coverage
Time and Motion Studies
Patient Discharge
Diagnosis-Related Groups
Comorbidity
Patient Care
Chronic Disease
rating
comorbidity

ASJC Scopus subject areas

  • Medicine(all)
  • Education
  • Public Health, Environmental and Occupational Health
  • Nursing(all)

Cite this

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The relationship of residents' autonomy and use of a teaching hospital's resources. / Feinglass, Joseph M; Schroeder, J.; Martin, Gary J; Wallace, Warren Henry; Lyons, J.

In: Academic Medicine, Vol. 66, No. 9, 01.01.1991, p. 549-552.

Research output: Contribution to journalArticle

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