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Volume 47, Number 4, August 2014

Employing infectious disease physicians affects clinical and economic outcomes in regional hospitals: Evidence from a population-based study 

Chia-Pang Shih, Yi-Chun Lin, Yuk-Ying Chan, Kuang-Hung Hsu

Received: June 21, 2012    Revised: December 19, 2012    Accepted: January 25, 2013   


Corresponding author:

Kuang-Hung Hsu, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
Laboratory for Epidemiology, Department of Health Care Management, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
Corresponding Author InformationCorresponding author. 259, Wen-Hwa 1st Road, Kwei-Shan, Taoyuan 333, Taiwan. 


Background and purpose: 

Infectious disease physicians (IDPs) play a major role in patient care, infectious disease control, and antibiotic use in hospitals. The aim of this research is to explore the effects of employment of IDPs on patients' prognosis and the related medical and antibiotic expenses in hospitals. 



This population-based study provides evidence-based information on IDPs' contribution to patients' prognosis and antibiotic expenditure containment with inpatient claim data from the Taiwan Bureau of National Health Insurance in 2004. We further classified regional hospitals into those with and without IDPs and analyzed patient prognosis, length of stay, total medical expenses, and antibiotic expenses to test the effects of IDPs. 



The likelihood of developing a poor prognosis among patients was found to be higher in non-IDP hospitals, with an odds ratio of 1.14 and a 95% confidence interval of 1.05–1.23 (p = 0.002). Medical expenses, excluding those of nonrestricted drugs, were found to be higher in the non-IDP group than in the IDP group. The total medical expenses were also found to be 10% higher in the non-IDP group than in the IDP group (p < 0.001).



Employment of IDPs was likely to improve patient prognosis and reduce overall medical expenses. It is suggested that healthcare administrators consider the employment of or investment in IDPs as a cost-effective strategy for improving patient quality of care. 


Key words:

Antibiotic prescriptions, Infectious disease physicians, Regional hospitals, Total medical expenses, Treatment outcomes