Outcomes of care by hospitalists, general internists, and family physicians
Outcomes of care by hospitalists, general internists, and family physicians
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DOI：
10.1056/nejmsa067735
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发表时间：
2007-12-20
影响因子：
158.5
通讯作者：
Auerbach, Andrew D.
中科院分区：
文献类型：
--
作者：
Lindenauer, Peter K.;Rothberg, Michael B.;Auerbach, Andrew D.
背景：住院医师模式正在迅速改变美国住院患者护理的格局，然而，关于住院医师护理的临床和经济结果的证据来自于对少数医生的实践进行检验的少量单家医院研究。方法：我们对 2002 年 9 月至 2005 年 6 月期间因肺炎、心脏病住院的 76,926 名 18 岁或以上患者进行了回顾性队列研究。 美国 45 家医院治疗衰竭、胸痛、缺血性中风、尿路感染、慢性阻塞性肺病急性加重或急性心肌梗塞。我们使用多变量模型比较了 284 名住院医师、993 名普通内科医生和 971 名家庭医生的护理结果。结果：与普通内科医生护理的患者相比，住院医师护理的患者的住院时间稍短（调整后的差异为 0.4 天；P
Background: The hospitalist model is rapidly altering the landscape for inpatient care in the United States, yet evidence about the clinical and economic outcomes of care by hospitalists is derived from a small number of single-hospital studies examining the practices of a few physicians.Methods: We conducted a retrospective cohort study of 76,926 patients 18 years of age or older who were hospitalized between September 2002 and June 2005 for pneumonia, heart failure, chest pain, ischemic stroke, urinary tract infection, acute exacerbation of chronic obstructive pulmonary disease, or acute myocardial infarction at 45 hospitals throughout the United States. We used multivariable models to compare the outcomes of care by 284 hospitalists, 993 general internists, and 971 family physicians.Results: As compared with patients cared for by general internists, patients cared for by hospitalists had a modestly shorter hospital stay (adjusted difference, 0.4 day; P