Link to article at PubMed
Shared by Robert Mahoney
Link: http://archinte.ama-assn.org/cgi/content/short/168/12/1257?rss=1
INTRODUCTION
What is a hospitalist inpatient system? How do we define improving
patient care outcomes (PCOs)? To what alternative are we comparing
a hospitalist inpatient system?
We have been asked to debate a proposition that raises many questions. I submit that per se a hospitalist inpatient system does not improve PCOs. I will base my argument on several major points.
DEFINING HOSPITALIST SYSTEMS
First, hospitalist "systems" vary greatly among hospitals. We
cannot evaluate hospitalist systems generically because of their
great variation. Second, we must look at all outcomes. We cannot
focus just on hospital outcomes; we must include long-term outcomes.
The hospitalist model might have positive or negative effects
on trust and satisfaction. Third, we must consider the relative
importance of physician factors and system factors. We must
include continuity factors—both in the hospital and across
settings.
The first explicit discussion of the job description hospitalist came in the classic . . .