Rigorous Evaluation Of "Hospitalist" Model Needed To Determine Impact Of This New Medical Specialty, According To UCSF Health Policy Researchers

In today's increasingly competitive health care environment, many changes are occurring to improve patients' clinical outcomes and to decrease costs. One change includes the recent introduction of the hospital-based generalist physician, known as the hospitalist -- doctors who specialize in the care of hospital patients. The question remains does this new specialty provide improved health care?

A new report by UC San Francisco health policy researchers says a rigorous evaluation of the system is needed to address these concerns and assess the full impact of the hospitalist model.

"Measuring the quality and outcomes of health care is a complex process," said Jonathan Showstack, PhD, MPH, UCSF professor of medicine and health policy and associate director of the UCSF Institute for Health Policy Studies. "Rigorous evaluations must be conducted to provide convincing evidence concerning health status outcomes, the satisfaction of patients, providers, and trainees, and the costs of care."

Showstack and colleagues discuss the many components involved in evaluating the impact of hospitalists in the supplement of the February 16 issue of the Annals of Internal Medicine.

The hospitalist is a departure from the way doctors have traditionally functioned in the American academic hospital. Traditionally, the care of hospital patients has been managed by residents, who are medical school graduates in the late stages of training in academic medical centers. Residents work under the supervision of faculty members who rotate in that role infrequently, often just one month each year, according to the researchers. Patients' primary care doctors traditionally manage their care in non-teaching hospitals.

The emergence of hospitalists is based on the idea that inpatient care specialists will be better skilled, more efficient and more available to hospitalized patients than primary care physicians or residents.

The hospitalist model, said Showstack, has

Contact: Lordelyn P. del Rosario
University of California - San Francisco

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