Hospital stay in internal medicine hospitalist function
Main Article Content
Keywords
Hospitalization, Length of stay, Internal medicine, Hospitalists, Physician’s role
Abstract
Background: hospitalists are physicians who focus all of their clinical efforts on the management of hospital inpatients.
Objective: to evaluate if the presence of hospitalist physician is associated with a shorter length of stay (LOS).
Methods: hospitalized patients in the Medicine Interne Department of two second care government hospitals. LOS was defined as ≥ 9 days and hospital admission was classified as medical and no-medical.
Results: the principal cause of longer no-medical LOS was medical or surgical procedures delay. The hospital with hospitalist had significantly lower frequency of LOS (26 % adversus 34 %, p = 0.05), higher number of weekends discharges (35 % adversus 21 %, p = 0.01) and minor days of hospitalization 6.3 ± 5.2 adversus 8.0 ± 6.2, p = 0.002) than the hospital without hospitalist.
Conclusions: the hospitalist model seeks to more cost-effective patient care.
References
Negro-Álvarez JM, Guerrero-Fernández IM, Ferrándiz-Gomis R. El protocolo de evaluación del uso inapropiado de la hospitalización (the appropriateness evaluation protocol) en alergología. Rev Esp Alergol Inmunol Clin 1998;13(3):171-180. Disponible en http://revista.seaic.es/junio98/171-180.pdf
Nardi R, Scanelli G, Tragnone A, Lolli A, Kalfus P, Baldini A, Ghedini T, et al. Difficult hospital discharges in internal medicine wards. Intern Emerg Med 2007;2(2):95-99.
Vetter N. Inappropriately delayed discharge from hospital: What do we know? BMJ 2003;326(7395):927-928.
Lim SC, Doshi V, Castasus B, Lim JK, Mamun K. Factors causing Delay in discharge of elderly patients in an acute care hospital. Ann Acad Med 2006;35(1):27-32.
Wachter RM, Goldman L. The emerging role of hospitalists in the American health care system. N Engl J Med 1996; 335(7):514-517.
Kuo YF, Sharma G, Freeman JL, Goodwin JS. Growth in the care of older patients by hospitalists in the United States. N Engl J Med 2009;360(11):1102-1112.
Mcalearney AS. Hospitalists and family physicians: understanding opportunities and risks. J Fam Pract 2004; 53(6):473-481.
Aguirre-Gas H, García-Melgar M, Garibaldi-Zapatero J. Los factores asociados con la estancia hospitalaria prolongada en una unidad de tercer nivel. Gac Med Mex 1997;133 (2):71-77.
McMullarn R, Silke B, Bennett K, Callachand S. Resource utilization, length of hospital stay, and pattern of investigation during acute medical hospital admission. Postgrad Med J 2004;80(939):23-26.
Gregory D, Baigelman W, Wilson IB. Hospital economics of the Hospitalist. Health Serv Res 2003;38(3): 905-918.
Lindenauer PK, Rothberg MB, Pekow PS, Kenwood, C, Benjamin EM, Auerbach AD. Outcomes of care by hospitalists, general internists, and family physician. N Engl J Med 2007;357(25):2589-2600.
Hamel MB, Drazen JM, Epstein, AM. The growth of hospitalists and the changing face of primary care. N Engl J Med 2009;360(11):1141-1143.