Hospitalist systems

Institute for Clinical Systems Improvement
Record ID 32003000555
Authors' objectives:

This review aims to assess the available evidence on the effectiveness of hospitalist systems. Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to hospital care.

Authors' recomendations: With regard to hospitalist systems, the ICSI Technology Assessment Committee finds that: There are many different hospitalist models and the concept is still in development so generalization is difficult. The success or failure of a particular hospitalist model in a particular setting is not predictive of the success or failure of that model or another model in another setting. The hospitalist systems described in the published literature are safe relative to traditional hospital care. Morbidity and mortality are unchanged. The majority of hospitalist systems described in the published literature are effective in reducing costs, due primarily to reduced length of stay (Conclusion Grade I). Readmission rates are unaffected. One study reported decreased practice variation with hospital-based attending physicians. Potential benefits of hospitalist systems for physicians and patients have received less attention: a. Based on findings from three studies, the majority of physicians (inpatient and outpatient) responding expressed satisfaction with the hospitalist approaches studied and perceived that quality of care was maintained or improved (Conclusion Grade II). There remained a concern about loss of continuity of care. In one study, residents expressed greater satisfaction with hospital-based attending physicians. There have been no studies of the impact on acute care skills of physicians who no longer see inpatients. b. In one study, patients reported easier access to and improved quality of outpatient care. In two studies, there were no differences in patient satisfaction under hospitalist approaches vs. traditional approaches. (Conclusion Grade II) Training of residents may be enhanced by the availability and expertise of hospitalists in inpatient teaching settings but this may increase hospitalist system costs. The number of hospitalist systems is increasing rapidly.
Authors' methods: Review
Project Status: Completed
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Hospital Administration
  • Hospitalists
  • Hospital-Physician Relations
  • Physician-Patient Relations
Organisation Name: Institute for Clinical Systems Improvement
Contact Address: 8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675
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Copyright: Institute for Clinical Systems Improvement (ICSI)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.