Study shows dramatic growth in number of hospitalists

Mar 11, 2009

One of the most striking changes in health care over the last two decades has been a dramatic increase in physicians categorized as "hospitalists" — doctors who practice almost exclusively in hospitals, rather than combining both outpatient and inpatient care. But while observers of medical trends knew that the number of hospitalists was rising, there was no national or population-based data on hospitalist care.

Now, researchers at the University of Texas Medical Branch at Galveston have produced the first quantitative analysis of the increase in the number of hospitalists. In a paper appearing in the March 12 issue of the , UTMB associate professor Yong-Fang Kuo uses to calculate that the percentage of physicians practicing as hospitalists jumped from 5.9 percent in 1995 to 19 percent in 2006.

"These analyses show a substantial increase in the care of hospitalized patients by hospitalists," Kuo said. "Many researchers have raised questions about the growth of care having an impact on the continuity of patient care, the role of the primary care physician, and the patient-physician relationship. This study doesn't answer those questions, but it does give us the first real statistical picture of the phenomenon."

In the paper, Kuo and her co-authors (assistant professor Gulshan Sharma and professors Jean Freeman and James Goodwin) defined a hospitalist as a general internist who derived 90 percent or more of his or her Medicare evaluation-and-management claims from the care of hospitalized patients. Applying this criterion to the physicians who cared for 5 percent of Medicare beneficiaries in 1995, 1997 and 1999, as well as the period from 2001 through 2006, they were able to draw a statistical picture not only of the rise of hospitalist care, but also an increase in the percentage of physicians who primarily saw patients in outpatient settings.

"We're seeing a decrease in the percentage of physicians in general internal medicine with a balanced distribution between inpatient and outpatient services — the traditional office-based general internal medicine physician who also goes to the hospital to treat his or her patients when they need acute care," Kuo said.

Using the Medicare data, the researchers showed increases in hospitalist care over time for patients with different diagnoses and at hospitals of different sizes, and were able to map regional growth in hospitalist care. In 2006, there was marked geographic variation in the rates of care provided by hospitalists, with rates of more than 70 percent in some hospital referral regions. "Although the growth of care by hospitalists has been greater in certain geographic areas, substantial growth occurred in every area." Kuo said.

The UTMB researchers' article is accompanied by an editorial, "The Growth of Hospitalists and the Changing Face of Primary Care." Taking the information presented in the paper as a jumping-off point, the editorial examines the origins of hospitalist care and discusses studies of its benefits and problems.

Source: University of Texas Medical Branch at Galveston (news : web)

Explore further: Experts call for higher exam pass marks to close performance gap between international and UK medical graduates

add to favorites email to friend print save as pdf

Related Stories

Benefits of hospitalist care confirmed in new study

Dec 20, 2007

In the largest study to date evaluating the outcome of in-hospital care by various physician types, findings show that care by hospitalists resulted in shorter stays and lower costs to patients. Study results are reported ...

Wal-Mart to enter medical records digitization market

Mar 11, 2009

US retail titan Wal-Mart is poised to enter the medical data market with the launch of a package that would help small doctor's practices to digitize their medical records, a spokeswoman said Wednesday.

Recommended for you

What are the chances that your dad isn't your dad?

Apr 16, 2014

How confident are you that the man you call dad is really your biological father? If you believe some of the most commonly-quoted figures, you could be forgiven for not being very confident at all. But how ...

New technology that is revealing the science of chewing

Apr 15, 2014

CSIRO's 3D mastication modelling, demonstrated for the first time in Melbourne today, is starting to provide researchers with new understanding of how to reduce salt, sugar and fat in food products, as well ...

After skin cancer, removable model replaces real ear

Apr 11, 2014

(HealthDay)—During his 10-year struggle with basal cell carcinoma, Henry Fiorentini emerged minus his right ear, and minus the hearing that goes with it. The good news: Today, the 56-year-old IT programmer ...

User comments : 0

More news stories

Leeches help save woman's ear after pit bull mauling

(HealthDay)—A pit bull attack in July 2013 left a 19-year-old woman with her left ear ripped from her head, leaving an open wound. After preserving the ear, the surgical team started with a reconnection ...

Male monkey filmed caring for dying mate (w/ Video)

(Phys.org) —The incident was captured by Dr Bruna Bezerra and colleagues in the Atlantic Forest in the Northeast of Brazil.  Dr Bezerra is a Research Associate at the University of Bristol and a Professor ...

Scientists tether lionfish to Cayman reefs

Research done by U.S. scientists in the Cayman Islands suggests that native predators can be trained to gobble up invasive lionfish that colonize regional reefs and voraciously prey on juvenile marine creatures.