generated controversy. Some research
suggests that the model is associated with lower costs and with comparable or
better patient outcomes. Concerns have been expressed, however that patients
will be dissatisfied with hospital care because of lack of physician continuity
and that referring physicians will be dissatisfied because of the loss of
control of their hospital patients, he added. There have also been concerns
that costs may actually be higher for the hospital and, perhaps most
importantly, health status outcomes may be affected adversely by the transfer of
responsibility of a patient from their primary care physician to an inpatient
generalist physician.
To provide evidence of the value of the hospitalist model, Showstack and
colleagues recommend quality of care should be evaluated through the measurement
of both processes and outcomes.
In addition, an evaluation of the hospitalist model requires an adequate
research design, Showstack said, which includes the following components:
- A precise definition of the model.
- Intervention and control groups.
- Collection of patient clinical and demographic information.
- The specification of both process and outcome measures.
- Use of statistical techniques appropriate to the question(s) being asked and
the data that are collected.
- A design that distinguishes between outcomes attributable to the introduction
of hospitalists and other changes in medical treatments and the organization of
care.
Co-authors are Patricia Katz, PhD, UCSF assistant professor of medicine and
health policy, UCSF Institute for Health Policy Studies, department of medicine
and Ellen Weber, MD, FACEP, UCSF associate clinical professor of medicine,
associate director of division of emergency medicine, department of medicine.
'"/>
Contact: Lordelyn P. del Rosario
LdelRosario@PubAff.ucsf.edu
415-476-2557
University of California - San Francisco
25-Feb-1999
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