Comparisons of clinical outcomes between weekday-only and full-time, 24-hour/7-day coverage hospitalistsystems

Seung Jun Han, Hee Won Jung, Do Youn Oh, Jae Hyun Lee, Sung do Moon, Sunhye Lee, Jung Hwan Yoon

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Abstract

Background: Since the launch of pilot programs in 2016, varying ranges of hospitalist coverage exist in Korea. We evaluated the effects of differing depths of hospitalist coverage on clinical outcomes. Methods: This study retrospectively reviewed the records of 513 patients admitted to a medical hospitalist unit through emergency department at Seoul National University Hospital. The full-time group included patients admitted in 2018 who received 24/7 hospitalist service, whereas the weekday group included patients admitted in 2019 with only weekday hospitalist service. In-hospital clinical outcomes were compared between the two groups. Results: Unplanned intensive care unit admission rate was lower in the full-time group than in the weekday group (0.4% vs. 2.9%; P = 0.042). Discharges to local hospitals for subacute or chronic care were more frequent in the full-time group than in the weekday group (12.6% vs. 5.8%; P = 0.007). The weekday coverage was a predictive factor of in-ward mortality (odds ratio, 2.00; 95% confidence interval, 1.01-3.99) after adjusting for potential confounding factors. Conclusion: Uninterrupted weekend coverage hospitalist service is helpful for care-plan decision and timely care transitions for acutely and severely ill patients.

Original languageEnglish
Article numberE117
JournalJournal of Korean Medical Science
Volume35
Issue number18
DOIs
StatePublished - 1 May 2020

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Keywords

  • Hospital medicine
  • Hospitalists
  • Length of stay
  • Mortality

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