The status of hospital medicine groups in the United States
The status of hospital medicine groups in the United States
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DOI：
10.1002/jhm.82
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发表时间：
2006-03-01
影响因子：
2.6
通讯作者：
Huddleston, Jeanne M.
中科院分区：
文献类型：
--
作者：
Kralovec, Peter D.;Miller, Joseph A.;Huddleston, Jeanne M.
背景：医院医师被定义为负责管理住院患者医疗需求的医院医生，代表了医师专业化的一个重要趋势。然而，只有有限的轶事数据可以量化全国各地医院医学小组的状况。目的：利用2003年美国医院协会（AHA）年度调查数据，更好地了解医院人员流动的程度和性质。研究对象：美国4895家急症护理医院。测量方法：设有医院药品组的医院数量和百分比；每组平均住院人数；平均每日人口普查（ADC）的住院人数为100名患者；按就业模式分组分布。描述变量：人口普查地区；农村/城市地位;床位数；组织控制;教学的地位。结果：美国约有1415个医院医学小组和1159名医院医生。医院医学小组在医院的整体渗透率为29%（在拥有200张或更多床位的医院为55%），在拥有医院医学小组的医院，每100名ADC有3.93名医院医生对医院产生影响。医院医学组平均有7.9名医生。医院医学群体的三种主要就业模式：医院员工、独立提供者群体和医生群体之间的分布相当平均。根据各个医院的特点，所有这些措施可能差别很大。结论：医院医学似乎已成为美国主流医疗保健服务的一部分。没有医院医学集团的就业模式在该专业占主导地位。我们预计，医院医药集团的实施将继续保持增长和多样性。
BACKGROUND: Hospitalists, defined as hospital-based physicians who take responsibility for managing the medical needs of inpatients, represent a significant trend in physician specialization. However, only limited anecdotal data quantifying the status of hospital medicine groups around the country is available.OBJECTIVE: To better understand the extent and nature of the hospitalist movement, utilizing data from the 2003 Annual Survey of the American Hospital Association (AHA).STUDY POPULATION: 4895 acute care hospitals in the United States.MEASUREMENTS: Number and percentage of hospitals with hospital medicine groups; mean number of hospitalists per group; hospitalists per average daily census (ADC) of 100 patients; distribution of groups by employment model.DESCRIPTIVE VARIABLES: Census region; rural/urban status; number of beds; organizational control; teaching status.RESULTS: There are approximately 1415 hospital medicine groups and 11 159 hospitalists in the United States. The overall penetration of hospital medicine groups at hospitals is 29% (55% at hospitals with 200 or more beds), and the in-hospital impact at hospitals with hospital medicine groups is 3.93 hospitalists per 100 ADC. The average hospital medicine group has 7.9 hospitalists. There is a fairly equal distribution among the 3 major employment models for hospital medicine groups: hospital employees, independent provider groups, and physician groups. All these measures can vary substantially, depending on the characteristics of individual hospitals.CONCLUSIONS: Hospital medicine appears to have become part of the mainstream delivery of health care in the United States. No employment model of hospital medicine group appears to dominate this specialty. We expect there will continue to be growth and diversity in the implementation of hospital medicine groups.