The aim of the study was to assess a newly introduced hospitalist care model in a Singapore hospital. Clinical outcomes of the family medicine hospitalists program were compared with the traditional specialists-based model using the hospital's administrative database.
The family medicine hospitalist model was associated with reductions in hospital LOS and cost of care without adversely affecting mortality or 30-day all-cause readmission rate. These findings suggest that the hospitalist care model can be adapted for health systems outside North America and may produce similar beneficial effects in care efficiency and cost savings.
Wednesday, March 16, 2011
Monday, March 14, 2011
An interview with the 'father' of hospitalist medicine
Partners: Early on there was clearly some resistance to the concept of hospital medicine from other internists and other specialties. Do you find that is still the case today?
Wachter: Sure, and I actually would have been disappointed in my field had there not been. In order to achieve the advantages of having a hospitalist — and those advantages really are focused practice where this person becomes an expert in the management of sick hospitalized patients, available throughout the day and often the night, with on-site presence, and a level of coordination of hospital care that can’t be achieved by a primary care doctor trying to manage a hospitalized patient — in order to achieve those advantages there is a cost. That cost is a purposeful discontinuity of care, with the primary care doctor no longer maintaining the responsibility to manage a hospitalized patient. If I was a primary care doctor and I was being confronted with a model in which a different doctor would take care of my patient when he or she were very sick, that would bother me too. It’s really the reason why, in the early years of the field, our professional society, and our whole field really, came down very strongly against programs that were mandatory. We really felt that if the model develops and grows organically, and some primary care doctors see why there may be advantages to them and their patients in doing things this way, that over time it would grow of its own momentum. I think that has largely been what has happened.
Wachter: Sure, and I actually would have been disappointed in my field had there not been. In order to achieve the advantages of having a hospitalist — and those advantages really are focused practice where this person becomes an expert in the management of sick hospitalized patients, available throughout the day and often the night, with on-site presence, and a level of coordination of hospital care that can’t be achieved by a primary care doctor trying to manage a hospitalized patient — in order to achieve those advantages there is a cost. That cost is a purposeful discontinuity of care, with the primary care doctor no longer maintaining the responsibility to manage a hospitalized patient. If I was a primary care doctor and I was being confronted with a model in which a different doctor would take care of my patient when he or she were very sick, that would bother me too. It’s really the reason why, in the early years of the field, our professional society, and our whole field really, came down very strongly against programs that were mandatory. We really felt that if the model develops and grows organically, and some primary care doctors see why there may be advantages to them and their patients in doing things this way, that over time it would grow of its own momentum. I think that has largely been what has happened.
Friday, March 11, 2011
Patient Satisfaction With Hospitalists
Despite concerns and disagreements about the impact of hospitalist models on health care, hospitalists are becoming the dominant means of providing inpatient care, and models continue to diversify. Understanding their impact and the factors that influence their adoption is essential. This study examined hospitalists' impact on patient satisfaction, considering a host of characteristics. [READ FULL ARTICLE]
Thursday, March 10, 2011
Saturday, February 26, 2011
Thursday, February 24, 2011
Jamie speaks about Pan American Hospital Medicine issues. Listen and comment
"It took many years to Hospital Medicine to grow in the USA. It has taken ten years to be a full specialty. At first there was only a few hundred doctors doing it and people thought it wouldn’t last, and now there is tens of thousand hospitalists in the USA, it is a huge growth. But it took five or six to start really growing and in the last three or four to really expand. It is a ten year process!"
Tuesday, February 22, 2011
Sunday, February 20, 2011
Friday, February 18, 2011
PASHA2010 from a fifth-year medical student from Universidade Positivo, Curitiba, Brazil point of view
The meeting, held in November at a beautiful beach resort in Florianópolis in southern Brazil, was pioneering in several aspects...
PASHA2010: An Argentine perspective
Daniel Grassi speaks about the meeting and about the Hospital Medicine in Argentina. Listen and comment.
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