A new JAMA Network report on quality of care found no significant difference in 30-day mortality rates when patients are treated by locum tenens physicians compared to non-locum tenens physicians.
In addition to no significant difference in terms of mortality, patients treated by locum tenens physicians had higher Part B spending ($1,836 compared to $1,712), longer lengths of stay (a mean of 5.64 days compared to 5.21 days) and lower 30-day readmissions (22.8% compared to 23.83%).
The report analyzed data from more than 1.8 million Medicare beneficiaries hospitalized between 2009 and 2014.
Hospital and health systems continuously look for ways to make up for sagging reimbursements and lower admissions. Hospital leaders will like the study findings that showed no differences concerning mortality rates and lower readmission rates, but they’ll also be interested that locum tenens physicians caused higher spending and longer lengths of stay.
These findings are especially important considering that the healthcare system is transitioning from fee-for-service to value-based payment programs. Making sure physicians are not causing more spending and longer lengths of stay could play a part in value-based arrangements.
Locum tenens often fill the gaps, especially regarding areas that face doctor shortages. Staff Care conducted a survey this year on temporary physician trends and found that 94% of healthcare facility managers reported using locum tenens within the past year. That’s an increase from 74% in 2012.
Locum tenens are helping fill gaps, but hospitals will need to make sure bringing on temporary physicians does not hurt their quality numbers. Quality and outcomes are becoming an increasingly critical piece of hospital payments. Health systems might become hesitant of going with locum tenens physicians if it means a drop in quality and outcomes and increases costs.
In this study, researchers compared quality and costs of hospital care delivered by both locum tenens and non-locum tenens internal medicine physicians. In addition to mortality rates and Medicare Part B spending, researchers also looked at length of stay and 30-day readmissions. Of the more than 1.8 million Medicare admissions reviewed, more than 38,000, about 2%, received care from a locum tenens physicians.
Though locum tenens physicians have increased in the U.S., research about their quality and costs of care are limited, according to the researchers. The researchers said additional research may “help determine hospital-level factors associated with the quality and costs of care related to locum tenens physicians.”