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Research Article: Impact of hospitalist care model on patient outcomes in acute medical unit: a retrospective cohort study

Date Published: 2023-08-03

Abstract:
Objective To assess a newly introduced, hospitalist-run, acute medical unit (AMU) care model at a tertiary care hospital in the Republic of Korea. Design Retrospective cohort study. Setting Tertiary care hospital in the Republic of Korea. Participants We evaluated 6391 medical inpatients admitted through the emergency department (ED) from 1 June 2016 to 31 May 2017. Interventions The study compared multiple outcomes among medical inpatients from the ED between the non-hospitalist group and the AMU hospitalist group. Outcome measures In-hospital mortality (IHM), intensive care unit (ICU) admission rate, hospital length of stay (LOS), ED-LOS and unscheduled readmission rates were defined as patient outcomes and compared between the two groups. Results Compared with the non-hospitalist group, the AMU hospitalist group had lower IHM (OR: 0.43, p<0.001), a lower ICU admission rate (OR: 0.72, p=0.013), a shorter LOS (coefficient: ?0.984, SE: 0.318; p=0.002) and a shorter ED-LOS (coefficient: ?3.021, SE: 0.256; p<0.001). There were no significant differences in the 10-day or 30-day readmission rates (p=0.974, p=0.965, respectively). Conclusions The AMU hospitalist care model was associated with reductions in IHM, ICU admission rate, LOS and ED-LOS. These findings suggest that the AMU hospitalist care model has the potential to be adopted into other healthcare systems to improve care for patients with acute medical needs.

Introduction:
The hospitalist care model in South Korea was introduced to improve the quality of inpatient care and to address the issue of a reduced number of available medical residents—owing to the Resident Act, which limited their work hours to 80/week. 1 As of July 2019, approximately 140 physicians in South Korea work as hospitalists and are in charge of approximately 2200 beds in 22 tertiary hospitals and 10 general hospitals. 1 A hospitalist—a medical doctor in charge of inpatient care during hospital stays—is defined…

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