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

• Published in: Journal of Korean medical science Vol. 34; no. 25; pp. e179 - 13
• Main Authors: Lee, Jung Hwan, Kim, Ah Jin, Kyong, Tae Young, Jang, Ji-Hun, Park, Jeongmi, Lee, Jeong Hoon, Lee, Man-Jong, Kim, Jung-Soo, Suh, Young Ju, Kwon, Seong-Ryul, Kim, Cheol-Woo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.07.2019; 대한의학회
• Subjects: Adult; Aged; Aged, 80 and over; Comorbidity; Female; Hospital Mortality; Hospitalists; Humans; Length of Stay; Linear Models; Male; Middle Aged; Models, Theoretical; Original; Pneumonia - epidemiology; Pneumonia - mortality; Pneumonia - pathology; Quality of Health Care; Republic of Korea - epidemiology; Retrospective Studies; Severity of Illness Index; Urinary Tract Infections - epidemiology; Urinary Tract Infections - mortality; Urinary Tract Infections - pathology; 의학일반; Republic of Korea; Length of Stay; Multiple Chronic Conditions; Hospitalist
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2019.34.e179

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. 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). HG LOS (median, interquartile range [IQR], 8 [5-12] days) was lower than NHG LOS (median [IQR], 10 [7-15] days), ( < 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 ( = 0.170). In a subgroup analysis, HG LOS was shorter than NHG LOS (median [IQR], 8 [5-12] vs. 10 [7-16] days, respectively, < 0.001) with CCI of ≥ 5 points. 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.