How physicians perceive hospitalist services after implementation: anticipation vs reality.
How physicians perceive hospitalist services after implementation: anticipation vs reality.
复制标题
实施后医生如何看待住院服务：预期与现实。
DOI：
10.1001/archinte.163.19.2330
复制
发表时间：
2003
影响因子：
--
通讯作者：
R. Phillips
中科院分区：
文献类型：
--
作者：
A. Auerbach;M. Aronson;Roger B. Davis;R. Phillips
目的
探讨新住院服务实施后，内科医师对住院医师模式的态度是否有所改变。
设计
1998年和2000年进行的横断面调查。
设置
三级护理医院在波士顿，马萨诸塞州。
科目
共有236名内科委员会认证的医生隶属于贝丝以色列女执事医疗中心。
主要观察指标
对住院病人照护态度与住院医师模式之问卷调查。我们使用多变量模型来确定与医生反应相关的因素。
结果
在2000年接受调查的医生中，有236人（69%）作出了答复; 145人（61%）在1998年也作出了答复。受访者的平均（SD）年龄为46.4（10.8）岁; 157人（66.5%）为男性; 146人（61.9%）为初级保健提供者。在2000年，更多的医生同意“照顾住院病人是对我的时间的低效利用”（P<0.001），“使用住院医生服务提高了护理质量”（P = 0.002）。在2000年，更多的医生不同意“使用住院医师服务降低了医生职业满意度”（P<.001），以及“使用住院医师服务对医患关系产生了不利影响”（P<.001）。在回答有关患者满意度或整体职业满意度的问题时没有发现差异。在多变量模型中，年龄较大的医生更倾向于住院医生模式;那些住院实践较繁忙的医生更倾向于消极（P<0.05）。医生专业或作为一个初级保健提供者是不相关的态度，对住院模式。
结论
以下经验与住院医师制度，医生的态度，包括对职业满意度和与病人的关系，对一个自愿住院模式的关注改善。未来的研究应该调查住院医生模式是否会影响患者的满意度和护理质量。
OBJECTIVE
To determine whether internists' attitudes toward the hospitalist model change after implementation of a new inpatient service.
DESIGN
Cross-sectional surveys performed in 1998 and 2000.
SETTING
Tertiary care hospital in Boston, Mass.
SUBJECTS
A total of 236 internal medicine board-certified physicians affiliated with Beth Israel Deaconess Medical Center.
MAIN OUTCOME MEASURES
Responses to survey items regarding attitude toward inpatient care and the hospitalist model. We used multivariable models to determine factors associated with physician responses.
RESULTS
Of physicians surveyed in 2000, 236 (69%) responded; 145 (61%) had also responded in 1998. The mean (SD) age of respondents was 46.4 (10.8) years; 157 (66.5%) were male; and 146 (61.9%) were primary care providers. In 2000, more physicians agreed that "caring for inpatients is an inefficient use of my time" (P<.001), and that "use of a hospitalist service improves quality of care" (P =.002). In 2000, more physicians disagreed that "use of a hospitalist service diminishes physician career satisfaction" (P<.001), and that "use of the hospitalist service adversely affects the physician-patient relationship" (P<.001). No differences were detected in responses to questions regarding patient satisfaction or overall career satisfaction. In multivariable models, older physicians were more likely to favor the hospitalist model; those with busier inpatient practices were more negative (P<.05 for each). Physician specialty or being a primary care provider was not associated with attitudes toward the hospitalist model.
CONCLUSIONS
Following experience with a hospitalist system, physician attitude, including concerns regarding career satisfaction and relationships with patients, toward a voluntary hospitalist model improved. Future research should investigate whether the hospitalist model affects patient satisfaction and quality of care.
影响因子：
--
作者：
Fernandez,A;Grumbach,K;Goitein,L;Vranizan,K;Osmond,DH;Bindman,AB
通讯作者：
Bindman,AB