Table 1.
Hospitalist performance | |||||||||
---|---|---|---|---|---|---|---|---|---|
Source | Design | Hospital type | Study population | Sample | Comparison | Quality score | Processes of care | Operating efficiency | Patient outcomes |
Abenhaim et al. [44] | RC | Teaching | Adults admitted to either GMS or medical short-stay unit | 2,722 | F vs. TWS | 8 | ↑,*,ǂ | ↑,*,ǂ | ↑,*,ǂ |
Auerbach et al. [85] | RC | Teaching | Adults admitted to GMS | 5,308 | A vs. C | 24 | - | ↑ | ↑ |
Auerbach and Pantilat [76] | RC | Teaching | Adults admitted to GMS who died while in hospital | 148 | A vs. C | 21 | ↑ | ↑ | |
Batsis et al. [94] | B/A | Teaching | Seniors admitted for surgical repair of hip fracture | 466 | Fb vs. TWS | 13 | -,* | ||
Bekmezian et al. [79] | RC | Paediatric teaching | Paediatric patients with oncologic, hematologic or gastroenterologic disease | 925 | F vs. TWS | 17 | ↑ | ↓,* | |
Bell et al. [52] | QE | Teaching (six sites) | All patients admitted to GMS | 1,078 | Mixed practice types | 6 | -,* | ||
Bellet and Whitaker [80] | B/A | Paediatric teaching | Paediatric patients admitted to GMS | 1,440 | A vs. TWS and C | 24 | -,* | ↑ | ↓,* |
Boyd et al. [95] | RC | Teaching | Paediatric patients admitted to GMS | 1,009 | P vs. TWS | 16 | ↓ | ||
Carek et al. [96] | RC | Community | Adults admitted to GMS | 5,453 | P vs. C P vs. TWS | 21 | ↓,* ↓ | -,* - | |
Craig et al. [61] | RC | Community (16 sites) | Adults admitted from one HMO to GMS | P vs. C | 8 | ↑,ǂ | -,ǂ | ||
Davis et al. [65] | RC | Community | All patients admitted to GMS | 2,124 | Pc vs. C | 13 | ↑,* | ↑ | - |
Dhuper and Choksi [86] | B/A | Teaching | All patients admitted to GMS | 10,966 | Ac vs. TWS | 14 | ↑,* | ||
Diamond et al. [13] | B/A | Teaching | Adults admitted to GMS | 3,299 | A vs. C | 16 | ↑,* | ↑,* | |
Dwight et al. [45] | RC | Paediatric teaching | Paediatric patients admitted to GMS | 3,807 | F vs. TWS | 22 | - | ↑ | - |
Dynan et al. [97] | RC | Teaching | All patients admitted to GMS | 5,543 | Fc vs. TWS | 14 | ↑ | - | |
Everett et al. [98] | RC | Community | All patients admitted to GMS | 11,750 | P vs. C | 15 | ↑ | - | |
Everett et al. [87] | RC | Teaching | All patients admitted to GMS | 22,792 | P vs. C P vs. TWS | 14 | ↑ ↓ | - ↑ | |
Freese et al. [60] | B/A | Community | All patients admitted to GMS | P vs. C | 6 | ↑,*,ǂ | ↑,*,ǂ | ||
Gittell et al. [63] | RC | Community | All patients admitted to GMS | 6,686 | P vs. C | 7 | ↑ | ↑ | |
Go et al. [51] | QE | Teaching (six sites) | Adults admitted to GMS with diagnosis of acute upper gastrointestinal haemorrhage | 450 | A vs. TWS | 22 | -,* | ↓ | - |
Gregory et al. [99] | B/A | Teaching | All patients admitted to GMS | 402 | F vs. TWS | 8 | ↑,* | -,* | |
Hackner et al. [68] | PC | Teaching | Adults on Medicaid admitted to GMS | 1,637 | A vs. C | 19 | ↑,* | ↑,* | -,* |
Halasyamani et al. [100] | RC | Teaching | Adults admitted to GMS | 10,595 | P vs. C A vs. C | 21 | ↑ ↑ | - - | |
Huddleston et al. [48] | RCT | Teaching | Adults undergoing elective hip or knee arthroplasty | 469 | Fb vs. TWS | 26 | ↑ | ↑ | |
Kaboli et al. [50] | QE | Teaching | All patients admitted to GMS | 1,706 | A vs. TWS | 23 | ↑ | - | |
Kearns et al. [56] | QE | Teaching | All patients admitted to GMS | 4,455 | A vs. TWS | 26 | -,* | - | - |
Khasgiwali et al. [101] | RC | Teaching | All patients admitted to GMS | 1,916 | P and A vs. TWS | 14 | -,* | -,* | -,* |
Krantz et al. [58] | B/A | Teaching | All patients admitted to chest pain observational unit | 493 | Pb vs. TWS | 19 | ↑,* | -,* | |
Kulaga et al. [78] | RC | Teaching | All patients admitted to GMS | 2,707 | A vs. C | 8 | ↑,*,ǂ | ↑,* | |
Kuo et al. [102] | RC | Mixed (4,359 sites) | 5% national sample of admissions among Medicare beneficiaries | 314,590 | Mixed practice types | 16 | ↑ | ||
Landrigan et al. [103] | TS | Paediatric teaching | Paediatric patients admitted to GMS from three HMOs | 7,748 | Ac vs. C | 15 | ↑ | - | |
Lindenauer et al. [74] | RC | Teaching | Adults admitted with heart failure | 326 | P and A vs. C | 14 | ↑ | ↑ | -,* |
Lindenauer et al. [92] | RC | Mixed (45 sites) | Adults admitted with pneumonia, heart failure, chest pain, stroke, UTI, COPD or acute MI | 76,926 | Mixed practice types | 20 | ↑ | - | |
Maa et al. [62] | B/A | Teaching | Adults undergoing surgical appendectomy | A vs. TWS | 7 | ↑,* | |||
Meltzer et al. [54] | QE | Teaching | All patients admitted to GMS | 6,511 | A vs. TWS | 20 | ↑ | ↑ | |
Molinari and Short [104] | B/A | Community | Adults admitted from one HMO | 1,319 | Pc vs. C | 8 | ↑ | ||
Ogershok et al. [66] | B/A | Paediatric teaching | Paediatric patients admitted to GMS | 2,177 | A vs. TWS | 14 | ↑,* | ↑,* | -,* |
Palacio et al. [88] | RC | Teaching | All patients admitted to GMS | 5,943 | F vs. TWS | 11 | ↑,* | ↑ | |
Palmer et al. [49] | QE | Teaching | All patients admitted to GMS | 2,464 | Ac vs. TWS | 25 | ↑,* | ↑ | ↑ |
Parekh et al. [105] | RC | Teaching | All patients admitted to GMS | 2,552 | A vs. TWS | 19 | - | - | |
Phy et al. [82] | B/A | Teaching | Older adults admitted for surgical repair of hip fracture | 466 | Fb,c vs. TWS | 15 | ↑ | -,* | |
Pinzuer et al. [77] | B/A | Teaching | Adults admitted for lower-extremity salvage or reconstructive surgery | 140 | Fb vs. TWS | 9 | ↑ | ↓,ǂ,* | |
Ravikumar et al. [83] | B/A | Teaching (four sites) | Adult surgical patients | 39,769 | Fb,c vs. TWS | 8 | ↓,ǂ,* | ↓,* | |
Reddy et al. [72] | RC | Teaching | All patients admitted with community-acquired pneumonia | 151 | A vs. C and TWS | 9 | - | - | |
Rifkin et al. [70] | RC | Community | Adults admitted with community-acquired pneumonia | 455 | P vs. C | 20 | ↑,* | ↑ | -,* |
Rifkin et al. [106] | RC | Teaching | All patients admitted to GMS | 11,388 | F vs. C | 18 | - | ||
Rifkin et al. [69] | RC | Community | All patients admitted with community-acquired pneumonia | 158 | F vs. C | 11 | ↑,* | ||
Roy et al. [30] | RC | Teaching | Adults admitted with hip fracture | 118 | F vs. C | 9 | ↑,* | ||
Roytman et al. [67] | RC | Teaching | Adults admitted with congestive heart failure | 342 | F vs. C | 20 | ↑ | ↑ | ↑ |
Salottolo et al. [89] | B/A | Teaching | Adult trauma admissions | 500 | F vs. TWS | 5 | ↓ | - | |
Scheurer et al. [107] | RC | Mixed (29 sites) | All patients admitted with bacterial pneumonia | 11,969 | Mixed practice types | 7 | ↑,* | ||
Schneider et al. [53] | QE | Teaching (six sites) | All admissions to GMS with HIV infection | 1,207 | A vs. TWS | 17 | - | - | - |
Sharma et al. [9] | RC | Mixed (11 sites) | Older adults on Medicaid with advanced lung cancer | 21,183 | Mixed practice types | 14 | ↓ | ||
Simon et al. [84] | B/A | Paediatric teaching | Paediatric patients undergoing spinal fusion | 759 | Fb vs. TWS | 8 | ↑ | ||
Sloan et al. [24] | B/A | Community VA | Adults admitted to inpatient psychiatric unit | 1,409 | Fc vs. Cc | 18 | -,* | ↑,* | |
Smith et al. [71] | RC | Teaching | Adults admitted with community-acquired pneumonia | 45 | P vs. C | 14 | - | ↓ | -,* |
Somekh et al. [59] | RC | Teaching | Admissions to GMS or cardiac observational unit for chest pain | 750 | F vs. C F vs. cardiologist | 11 | ↑,* ↓,* | ↓,ǂ ↓ | - ↓ |
Southern et al. [108] | RC | Teaching | All patients admitted to GMS | 9,037 | A vs. TWS | 19 | ↑ | - | |
Srivastava et al. [64] | B/A | Paediatric teaching | Paediatric patients from one HMO admitted with asthma, dehydration or viral illness | 1,970 | A vs. TWS | 19 | ↑ | ||
Stein et al. [73] | RC | Teaching | Adult admitted with community-acquired pneumonia | 237 | A vs. C | 11 | -,* | ↑,* | -,* |
Tenner et al. [57] | B/A | Paediatric teaching (two sites) | Paediatric admissions to ICU | 1,211 | P vs. TWS | 17 | ↑ | ↑ | |
Tingle and Lambert [109] | RC | Teaching | Adults admitted to GMS | 529 | F vs. TWS | 14 | - | -,* | |
Vasilevskis et al. [75] | RC | Teaching (six sites) | Adults with heart failure admitted to GMS | 372 | Mixed practice types | 18 | - | - | ↑ |
Wachter et al. [55] | QE | Teaching | All patients admitted to GMS | 1,623 | A vs. TWS | 18 | -,* | ↑ | - |
Wells et al. [110] | PC | Community | Paediatric patients admitted to GMS | 181 | P vs. C | 5 | ↑ | -,* |
aRCT, randomized, controlled trial; QE, quasi-experimental design; TS, time series; PC, prospective cohort; RC, retrospective cohort; B/A, before versus after; CS, cross-sectional survey; GMS, general medical service; HMO, health maintenance organization; UTI, urinary tract infection; COPD, chronic obstructive pulmonary disease; MI, myocardial infarction; HIV, human immunodeficiency virus; ICU, intensive care unit; P, private hospitalist attending physician; F, nonacademic faculty hospitalist attending physician; A, academic hospitalist attending physician; C, community-based physician; TWS, traditional academic attending physicians with teaching responsibilities; bhospitalists were comanaging their patients' care with comparison healthcare providers; cuse of physician's assistants, nurse practitioners and/or discharge planners in the provision of care; ↑ indicates improved performance by hospitalists; - indicates no difference in performance between providers; ↓ indicates worse performance by hospitalists; ǂ indicates that a P value or confidence interval was not provided, so results may or may not be statistically significant; *indicates that results are unadjusted.