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      KCI등재 SCI SCIE SCOPUS

      Evaluating the Outcome of Multi-Morbid Patients Cared for by Hospitalists: a Report of Integrated Medical Model in Korea

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      https://www.riss.kr/link?id=A106845969

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      다국어 초록 (Multilingual Abstract)

      Background: The lack of medical personnel has led to the employment of hospitalists in Korean hospitals to provide high-quality medical care. However, whether hospitalists' care can improve patients' outcomes remains unclear. We aimed to analyze the outcome in patients cared for by hospitalists.
      Methods: A retrospective review was conducted in 1,015 patients diagnosed with pneumonia or urinary tract infection from March 2017 to July 2018. After excluding 306 patients, 709 in the general ward who were admitted via the emergency department were enrolled, including 169 and 540 who were cared for by hospitalists (HGs) and non-hospitalists (NHGs), respectively. We compared the length of hospital stay (LOS), in-hospital mortality, readmission rate, comorbidity, and disease severity between the two groups. Comorbidities were analyzed using Charlson comorbidity index (CCI).
      Results: HG LOS (median, interquartile range [IQR], 8 [5–12] days) was lower than NHG LOS (median [IQR], 10 [7–15] days), (P < 0.001). Of the 30 (4.2%) patients who died during their hospital stay, a lower percentage of HG patients (2.4%) than that of NHG patients (4.8%) died, but the difference between the two groups was not significant (P = 0.170). In a subgroup analysis, HG LOS was shorter than NHG LOS (median [IQR], 8 [5–12] vs. 10 [7–16] days, respectively, P < 0.001) with CCI of ≥ 5 points.
      Conclusion: Hospitalist care can improve the LOS of patients, especially those with multiple comorbidities. Further studies are warranted to evaluate the impact of hospitalist care in Korea.
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      Background: The lack of medical personnel has led to the employment of hospitalists in Korean hospitals to provide high-quality medical care. However, whether hospitalists' care can improve patients' outcomes remains unclear. We aimed to analyze the o...

      Background: The lack of medical personnel has led to the employment of hospitalists in Korean hospitals to provide high-quality medical care. However, whether hospitalists' care can improve patients' outcomes remains unclear. We aimed to analyze the outcome in patients cared for by hospitalists.
      Methods: A retrospective review was conducted in 1,015 patients diagnosed with pneumonia or urinary tract infection from March 2017 to July 2018. After excluding 306 patients, 709 in the general ward who were admitted via the emergency department were enrolled, including 169 and 540 who were cared for by hospitalists (HGs) and non-hospitalists (NHGs), respectively. We compared the length of hospital stay (LOS), in-hospital mortality, readmission rate, comorbidity, and disease severity between the two groups. Comorbidities were analyzed using Charlson comorbidity index (CCI).
      Results: HG LOS (median, interquartile range [IQR], 8 [5–12] days) was lower than NHG LOS (median [IQR], 10 [7–15] days), (P < 0.001). Of the 30 (4.2%) patients who died during their hospital stay, a lower percentage of HG patients (2.4%) than that of NHG patients (4.8%) died, but the difference between the two groups was not significant (P = 0.170). In a subgroup analysis, HG LOS was shorter than NHG LOS (median [IQR], 8 [5–12] vs. 10 [7–16] days, respectively, P < 0.001) with CCI of ≥ 5 points.
      Conclusion: Hospitalist care can improve the LOS of patients, especially those with multiple comorbidities. Further studies are warranted to evaluate the impact of hospitalist care in Korea.

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      참고문헌 (Reference)

      1 엄중식, "호스피탈리스트 제도의 운영" 대한의사협회 59 (59): 342-344, 2016

      2 이동기, "입원환자전담의(Hospitalist) 제도의 준비 작업과 전망" 대한내과학회 91 (91): 241-244, 2016

      3 장성인, "미국의 호스피탈리스트 흐름과 한국형 호스피탈리스트 도입방안" 대한내과학회 89 (89): 1-5, 2015

      4 Wachter RM, "Zero to 50, 000-The 20th anniversary of the hospitalist" 375 (375): 1009-1011, 2016

      5 Quan H, "Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries" 173 (173): 676-682, 2011

      6 Singer M, "The third international consensus definitions for sepsis and septic shock (Sepsis-3)" 315 (315): 801-810, 2016

      7 Rachoin JS, "The impact of hospitalists on length of stay and costs : systematic review and meta-analysis" 18 (18): e23-e30, 2012

      8 Hamel MB, "The growth of hospitalists and the changing face of primary care" 360 (360): 1141-1143, 2009

      9 Yang Y, "The effect of comorbidity and age on hospital mortality and length of stay in patients with sepsis" 25 (25): 398-405, 2010

      10 Tadros RO, "The effect of a hospitalist comanagement service on vascular surgery inpatients" 61 (61): 1550-1555, 2015

      1 엄중식, "호스피탈리스트 제도의 운영" 대한의사협회 59 (59): 342-344, 2016

      2 이동기, "입원환자전담의(Hospitalist) 제도의 준비 작업과 전망" 대한내과학회 91 (91): 241-244, 2016

      3 장성인, "미국의 호스피탈리스트 흐름과 한국형 호스피탈리스트 도입방안" 대한내과학회 89 (89): 1-5, 2015

      4 Wachter RM, "Zero to 50, 000-The 20th anniversary of the hospitalist" 375 (375): 1009-1011, 2016

      5 Quan H, "Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries" 173 (173): 676-682, 2011

      6 Singer M, "The third international consensus definitions for sepsis and septic shock (Sepsis-3)" 315 (315): 801-810, 2016

      7 Rachoin JS, "The impact of hospitalists on length of stay and costs : systematic review and meta-analysis" 18 (18): e23-e30, 2012

      8 Hamel MB, "The growth of hospitalists and the changing face of primary care" 360 (360): 1141-1143, 2009

      9 Yang Y, "The effect of comorbidity and age on hospital mortality and length of stay in patients with sepsis" 25 (25): 398-405, 2010

      10 Tadros RO, "The effect of a hospitalist comanagement service on vascular surgery inpatients" 61 (61): 1550-1555, 2015

      11 Kim HW, "The current status of hospital medicine in Korea, 2019" 94 (94): 139-144, 2019

      12 Tong L, "The association between outpatient follow-up visits and all-cause non-elective 30-day readmissions : a retrospective observational cohort study" 13 (13): e0200691-, 2018

      13 Rosenthal GE, "Severity-adjusted mortality and length of stay in teaching and nonteaching hospitals. Results of a regional study" 278 (278): 485-490, 1997

      14 Williams JM, "Severity scores in emergency department patients with presumed infection : a prospective validation study" 44 (44): 539-547, 2016

      15 Hijazi HH, "Risk assessment of comorbidities on 30-day avoidable hospital readmissions among internal medicine patients" 23 (23): 391-401, 2017

      16 Burke RE, "Postdischarge clinics : hospitalist attitudes and experiences" 8 (8): 578-581, 2013

      17 Lindenauer PK, "Outcomes of care by hospitalists, general internists, and family physicians" 357 (357): 2589-2600, 2007

      18 Cabré M, "Oropharyngeal dysphagia is a risk factor for readmission for pneumonia in the very elderly persons : observational prospective study" 69 (69): 330-337, 2014

      19 Shapiro NI, "Mortality in Emergency Department Sepsis(MEDS)score predicts 1-year mortality" 35 (35): 192-198, 2007

      20 Shapiro NI, "Mortality in Emergency Department Sepsis(MEDS)score : a prospectively derived and validated clinical prediction rule" 31 (31): 670-675, 2003

      21 Moore C, "Medical errors related to discontinuity of care from an inpatient to an outpatient setting" 18 (18): 646-651, 2003

      22 Feng C, "Log transformation : application and interpretation in biomedical research" 32 (32): 230-239, 2013

      23 Shu CC, "Integrated postdischarge transitional care in a hospitalist system to improve discharge outcome : an experimental study" 9 (9): 96-, 2011

      24 Auerbach AD, "Implementation of a voluntary hospitalist service at a community teaching hospital : improved clinical efficiency and patient outcomes" 137 (137): 859-865, 2002

      25 Mahant S, "Hospitalists and the outpatient clinic : time to reconsider" 168 : 3-4, 2016

      26 Howell EE, "Hospitalists and an innovative emergency department admission process" 19 (19): 266-268, 2004

      27 Freed DH, "Hospitalists : Evolution, evidence, and eventualities" 23 (23): 238-256, 2004

      28 Southern WN, "Hospitalist care and length of stay in patients requiring complex discharge planning and close clinical monitoring" 167 (167): 1869-1874, 2007

      29 Kisuule F, "Hospital medicine beyond the United States" 11 : 65-71, 2018

      30 Health Insurance Review & Assessment Service, "Hospital Average Length of Stay by Diagnostic Categories in 2017 and 2018. Indicator Status"

      31 Bellet PS, "Evaluation of a pediatric hospitalist service: impact on length of stay and hospital charges" 105 (105): 478-484, 2000

      32 Shu CC, "Evaluating the performance of a hospitalist system in Taiwan : a pioneer study for nationwide health insurance in Asia" 6 (6): 378-382, 2011

      33 Meltzer D, "Effects of physician experience on costs and outcomes on an academic general medicine service : results of a trial of hospitalists" 137 (137): 866-874, 2002

      34 Kuo YF, "Effect of hospitalists on length of stay in the medicare population : variation according to hospital and patient characteristics" 58 (58): 1649-1657, 2010

      35 Ofori-Asenso R, "Effect of comorbidity assessed by the Charlson comorbidity index on the length of stay, costs and mortality among older adults hospitalised for acute stroke" 15 (15): E2532-, 2018

      36 Lim WS, "Defining community acquired pneumonia severity on presentation to hospital : an international derivation and validation study" 58 (58): 377-382, 2003

      37 Sharma G, "Continuity of outpatient and inpatient care by primary care physicians for hospitalized older adults" 301 (301): 1671-1680, 2009

      38 Matsui K, "Comorbidity as a correlate of length of stay for hospitalized patients with acute chest pain" 11 (11): 262-268, 1996

      39 Stavem K, "Charlson comorbidity index derived from chart review or administrative data : agreement and prediction of mortality in intensive care patients" 9 : 311-320, 2017

      40 Landefeld CS, "Care of hospitalized older patients : opportunities for hospital-based physicians" 1 (1): 42-47, 2006

      41 Hock Lee K, "Bringing generalists into the hospital : outcomes of a family medicine hospitalist model in Singapore" 6 (6): 115-121, 2011

      42 Goodwin JS, "Association of hospitalist years of experience with mortality in the hospitalized medicare population" 178 (178): 196-203, 2018

      43 Kuo YF, "Association of hospitalist care with medical utilization after discharge : evidence of cost shift from a cohort study" 155 (155): 152-159, 2011

      44 Bell CM, "Association of communication between hospital-based physicians and primary care providers with patient outcomes" 24 (24): 381-386, 2009

      45 Howrey BT, "Association of care by hospitalists on discharge destination and 30-day outcomes after acute ischemic stroke" 49 (49): 701-707, 2011

      46 Weng TC, "Application of integrated medical care model(hospitalist)in emergency department and its efficiency and outcome : 4 years' experience in Taiwan" 5 (5): 211-216, 2017

      47 온정헌, "An Acute Medical Unit in a Korean Tertiary Care Hospital Reduces the Length of Stay and Waiting Time in the Emergency Department" 대한의학회 32 (32): 1917-1920, 2017

      48 Charlson ME, "A new method of classifying prognostic comorbidity in longitudinal studies : development and validation" 40 (40): 373-383, 1987

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      학술지 이력

      학술지 이력
      연월일 이력구분 이력상세 등재구분
      2023 평가예정 해외DB학술지평가 신청대상 (해외등재 학술지 평가)
      2020-01-01 평가 등재학술지 유지 (해외등재 학술지 평가) KCI등재
      2011-01-01 평가 등재학술지 유지 (등재유지) KCI등재
      2009-01-01 평가 등재학술지 유지 (등재유지) KCI등재
      2005-01-01 평가 SCI 등재 (등재유지) KCI등재
      2002-01-01 평가 등재학술지 선정 (등재후보2차) KCI등재
      1999-07-01 평가 등재후보학술지 선정 (신규평가) KCI등재후보
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      학술지 인용정보

      학술지 인용정보
      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 1.48 0.37 1.06
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
      0.85 0.75 0.691 0.11
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