The influence of a family practice residency on the costs of inpatient diagnostic testing.

A retrospective review of hospital records for 333 patients admitted to a large community teaching hospital by family physicians and family practice residents was performed to determine whether teaching programs in family practice led to a significant increase in the cost of care to patients. Three patient populations were identified for comparison: patients admitted by private family physicians when residents were not involved in patient care, patients admitted by the same family physicians while they served as attending physicians on the family practice service and allowed residents to participate in the care of their patients, and patients admitted by residents from the patient population at the Family Practice Center. After taking into account differences in case mix, an analysis of laboratory charges, radiology use, frequency of procedures, and use of consultants showed that the three groups were not different. Family practice residents managed their own patients as cost effectively as physicians in private practice, which suggests that experience alone is not necessary to develop methods of cost-efficient care. When these two groups were combined into a teaching unit, with few exceptions this efficiency was maintained. These results imply that the introduction of family practice residents into patient care does not invariably increase expenses to the patient.