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KMID : 0191120200350180117
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Journal of Korean Medical Science
2020 Volume.35 No. 18 p.117 ~ p.117
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Comparisons of Clinical Outcomes between Weekday-Only and Full-Time, 24-Hour/7-Day Coverage Hospitalist Systems
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Han Seung-Jun
Jung Hee-Won
Oh Do-Youn
Lee Jae-Hyun
Moon Sung-Do
Lee Sun-Hye
Yoon Jung-Hwan
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Abstract
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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.
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KEYWORD
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Hospitalists, Hospital Medicine, Mortality, Length of Stay
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