Skip Navigation
American College of Physicians Logo
  • Subscribe
  • Submit a Manuscript
  • Sign In
    Sign in below to access your subscription for full content
    INDIVIDUAL SIGN IN
    Sign In|Set Up Account
    You will be directed to acponline.org to register and create your Annals account
    INSTITUTIONAL SIGN IN
    Open Athens|Shibboleth|Log In
    Annals of Internal Medicine
    SUBSCRIBE
    Subscribe to Annals of Internal Medicine.
    You will be directed to acponline.org to complete your purchase.
Annals of Internal Medicine Logo Menu
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives
  • Author Info
Advanced Search
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Summaries for Patients |3 December 2002

Hospitalists and the Costs and Outcomes of Hospital Care

  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Jump To
  • Full Article
  • FULL ARTICLE
  • FULL ARTICLE
    • What is the problem and what is known about it so far?
    • Why did the researchers do this particular study?
    • Who was studied?
    • How was the study done?
    • What did the researchers find?
    • What were the limitations of the study?
    • What are the implications of the study?
  • Figures
  • Tables
  • Supplements
  • Audio/Video
  • Summary for Patients
  • Clinical Slide Sets
  • CME / MOC
  • Comments
  • Twitter Link
  • Facebook Link
  • Email Link
More
  • LinkedIn Link
  • CiteULike Link

What is the problem and what is known about it so far?

American doctors have traditionally spent part of their days seeing patients in their offices and part seeing patients in the hospital. More severe and complicated illnesses in hospitalized patients and the specialized nature of hospital care make it difficult for doctors to split their time between the outpatient office and the hospital. It is difficult to keep up with the huge amount of information relevant to both settings. Furthermore, doctors are unavailable to hospitalized patients for much of the day if they are seeing patients in the office. For these reasons, many hospitals have begun to use doctors called hospitalists. Hospitalists spend their entire day taking care of hospitalized patients. They aim to improve quality of hospital care and reduce costs. But do hospitalists actually benefit patients?

Why did the researchers do this particular study?

To compare outcomes and costs for patients cared for by hospitalists and patients cared for by nonhospitalists.

Who was studied?

The researchers studied 5710 adult medical patients admitted to a community-based teaching hospital between July 1997 and June 1999. The hospitalists were five academic faculty based at the hospital, and the nonhospitalist doctors were 113 physicians based in the community.

How was the study done?

All patients were admitted to a housestaff team that included doctors in training (residents and interns) and medical students. Housestaff wrote all patient orders and provided 24-hour coverage for the patients. Hospitalists supervised the care of 1615 patients. Community physicians supervised care for 3693 patients whom they had also cared for as outpatients. The researchers compared lengths and costs of hospital stays, as well as the proportions of patients who died who had received care supervised by hospitalists and nonhospitalists.

What did the researchers find?

In the first year of the study, hospitalists' and nonhospitalists' patients stayed in the hospital for similar lengths of time. By year 2, hospitalists' patients stayed in the hospital an average of about half a day less than nonhospitalists' patients. Average hospital costs were similar for nonhospitalists and hospitalists in the first year but were $822 lower for hospitalists in the second year. In both years of the study, the proportions of patients who died in the hospital and within 1 to 2 months after discharge were lower among hospitalists' patients than nonhospitalists' patients.

What were the limitations of the study?

The study involved only five hospitalists and a single teaching hospital. The findings could be explained by differences in the levels of sickness or other patient factors or by differences in how housestaff interacted with hospitalists and nonhospitalists rather than by hospitalist care.

What are the implications of the study?

Hospitalists' patients appear to have shorter and less costly hospital stays and may be less likely to die in the hospital or within 1 to 2 months of leaving the hospital than nonhospitalists' patients. Hospitalists may have “learning curves,” and some of benefits of their care may not be clear until they have been practicing hospital medicine for more than a year.

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

This feature is available only to Registered Users

Subscribe/Learn More
Submit a Comment

0 Comments

PDF
Not Available
Citations
Citation

Hospitalists and the Costs and Outcomes of Hospital Care. Ann Intern Med. ;137:I–16. doi: 10.7326/0003-4819-137-11-200212030-00001

Download citation file:

  • Ris (Zotero)
  • EndNote
  • BibTex
  • Medlars
  • ProCite
  • RefWorks
  • Reference Manager

© 2019

×
Permissions

Published: Ann Intern Med. 2002;137(11):I-16.

DOI: 10.7326/0003-4819-137-11-200212030-00001

0 Citations

See Also

Implementation of a Voluntary Hospitalist Service at a Community Teaching Hospital: Improved Clinical Efficiency and Patient Outcomes
View MoreView Less

Related Articles

Annals for Hospitalists Inpatient Notes - Gender Equality in Hospital Medicine—Are We There Yet?
Annals of Internal Medicine; 167 (6): HO2-HO3
Annals for Hospitalists Inpatient Notes - Reducing Diagnostic Error—A New Horizon of Opportunities for Hospital Medicine
Annals of Internal Medicine; 165 (8): HO2-HO4
Update in Hospital Medicine: Evidence Published in 2011
Annals of Internal Medicine; 156 (12): 875-879
Hospitalists and the Costs and Outcomes of Hospital Care
Annals of Internal Medicine; 137 (11): I-25
View MoreView Less

Related Topics

Hospital Medicine

Hospital Medicine.

CME/MOC Activity Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
The Comments Feature Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
link to top

Content

  • Home
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives

Information For

  • Author Info
  • Reviewers
  • Press
  • Readers
  • Institutions / Libraries / Agencies
  • Advertisers

Services

  • Subscribe
  • Renew
  • Alerts
  • Current Issue RSS
  • Latest RSS
  • In the Clinic RSS
  • Reprints & Permissions
  • Contact Us
  • Help
  • About Annals
  • About Mobile
  • Patient Information
  • Teaching Tools
  • Annals in the News
  • Share Your Feedback

Awards and Cover

  • Personae (Cover Photo)
  • Junior Investigator Awards
  • Poetry Prize

Other Resources

  • ACP Online
  • Career Connection
  • ACP Advocate Blog
  • ACP Journal Wise

Follow Annals On

  • Twitter Link
  • Facebook Link
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
INSTITUTIONAL SIGN IN
Open Athens|Shibboleth|Log In
Annals of Internal Medicine
PURCHASE OPTIONS
Buy This Article|Subscribe
You will be redirected to acponline.org to sign-in to Annals to complete your purchase.
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×