Physician specialty and variations in the cost of treating patients with acute upper gastrointestinal bleeding

Background and Aims: Upper gastrointestinal tract bleeding is a frequent cause of hospitalization. The goal of this study was to assess whether the cost of treating patients with upper gastrointestinal bleeding varies among surgeons, internists, and gastroenterologists. Methods: A retrospective study of 124 patients admitted with acute upper gastrointestinal hemorrhage was performed. Patients were stratified into three groups based on a validated risk score; length of stay and hospital costs were compared among patients primarily cared for by internists, surgeons, and gastroenterologists. Results: The median length of stay (2 days) for patients admitted to the gastroenterology service was significantly shorter than for patients admitted under the care of other physicians (P < 0.05). The median hospitalization cost ($2856) for patients admitted to the gastroenterology service was significantly lower than for patients admitted to the other services (P < 0.01). There were no significant differences in the time to endoscopy among services. Conclusions: Patients admitted to an urban teaching hospital directly under the care of a gastroenterologist had shorter hospital stays that were significantly less costly than patients under the primary care of internists or surgeons. The difference in length of stay reflects the time interval between endoscopy and discharge.