The rapidly growing hospitalist model of inpatient care has now achieved many of the attributes of other medical specialties and seems destined to become the dominant model of hospital care in the United States, according to a study published in the January 23, 2002 issue of the Journal of the American Medical Association (JAMA).
The Hospitalist Movement Five Years Later, by researchers at UCSF Medical Center, says that the hospitalist field appears to be living up to its promise to improve the efficiency and perhaps the quality of hospital care.
Even skeptics now concede that it is here to stay, said Robert Wachter, MD, associate chairman of the UCSF department of medicine, lead author of the JAMA article, and the physician who first coined the term hospitalist in a 1996 issue of The New England Journal of Medicine (NEJM).
According to the UCSF study, hospital care provided by physicians (typically internists), who focus exclusively on hospitalized patients and are available throughout the day is less costly. In addition, hospitalists may provide a higher quality of inpatient care than that provided by many primary care physicians who have few hospitalized patients and can generally see patients only briefly once a day, said Wachter.
The model appears to have achieved its minimum goal of improving efficiency without adverse effects on quality, teaching, or patient satisfaction, said Lee Goldman, MD, chairman of the UCSF department of medicine and co-author of the article.
Fifteen of the 19 studies reviewed by UCSF researchers found significant decreases in both hospital costs (average decrease 13.4 %) and lengths of stay (average decrease 16.6%). Two other studies demonstrated lower lengths of stay, but no decreases in costs. The researchers noted that if the average American hospitalist cares for 600 inpatients yearly and generates a 10% savings over the average medical inpatient cost of $8,000, the nations 5,000 hosp
Contact: Maureen McInaney
University of California - San Francisco