Pressure to control costs has led more academic medical centres to hire hospital-based physicians, known as hospitalists. Their primary professional focus is hospital medicine. They provide care for medical inpatients. William N. Southern, M.D., M.S., and colleagues at Montefiore Medical Center, the University Hospital for Albert Einstein College of Medicine, New York, reviewed data on all patients discharged from a 381-bed teaching hospital between 2002, and 2004.
The patients were assigned to either a hospitalist or non-hospitalist. The teams were identical except for the type of physician conducting the rounds. During the study period, there were 9,037 discharges with sufficient data to be included in the analysis. Of these, 2,913 (32.2 percent) were cared for by hospitalists teams and 6,124 (67.8 percent) were cared for by non-hospitalist teams. The average length of stay in the hospitalist group was 5.01 days, compared with 5.87 days in the non-hospitalist group. There were no differences between the two groups in readmission or death rate in the hospital or within 30 days.
“Hospitalist care had the strongest association with length of stay in patients with specific diagnoses, including cerebrovascular accidents (strokes), congestive heart failure, pneumonia, sepsis, urinary tract infections and asthma/chronic obstructive pulmonary disease,” the authors of the study write. “The close monitoring and continuous presence offered by hospitalists may allow for earlier discharge because hospitalists are more likely to detect clinical improvement in real time and to make appropriate adjustments in treatment regimens.”
Hospitalist care was also more strongly associated with shorter length of stay in patients who had complex discharge planning needs, such as home health care services, rehabilitation or transfer to a nursing facility.
MEDICA.de; Source: American Medical Association