Hospitalists: Do they improve patient care?

In response to the changes in the delivery of health care, the concept of u sing hospitalists to care for inpatients has been steadily gaining populari ty. Theoretically, hospitalists could deliver cost-effective quality health care to hospitalized patients. Because the currently available literature provides insufficient data on the impact of hospitalists on patient care an d because many of the currently practicing hospitalists are trained in pulm onary and critical care medicine, we will review some of the available info rmation on hospitalists and intensivists in an effort to provide an overvie w of their potential impact on patient care. Various studies of hospitalist programs demonstrate that there might be a significant reduction in length of stay as well as the cost of inpatient care. In addition, some of the in tensivist studies suggest potential reduction in length of stay and mortali ty. Most of the data available, however, are methodologically weak and are anecdotal. Thus, there is an urgent need for well-designed, prospective, co ntrolled studies to evaluate the effect of hospitalist care on outcome meas ures such as length of stay, cost, patient satisfaction, and quality of car e. In addition, studies examining the indirect effects of hospitalists on o utpatient resource use are also needed.