Impact of hospitalist care model on patient outcomes in acute medical unit: a retrospective cohort study

Abstract

Objective To assess a newly introduced, hospitalist-run, acute medical unit (AMU) care model at a tertiary care hospital in the Republic of Korea.Design Retrospective cohort study.Setting Tertiary care hospital in the Republic of Korea.Participants We evaluated 6391 medical inpatients admitted through the emergency department (ED) from 1 June 2016 to 31 May 2017.Interventions The study compared multiple outcomes among medical inpatients from the ED between the non-hospitalist group and the AMU hospitalist group.Outcome measures In-hospital mortality (IHM), intensive care unit (ICU) admission rate, hospital length of stay (LOS), ED-LOS and unscheduled readmission rates were defined as patient outcomes and compared between the two groups.Results Compared with the non-hospitalist group, the AMU hospitalist group had lower IHM (OR: 0.43, p<0.001), a lower ICU admission rate (OR: 0.72, p=0.013), a shorter LOS (coefficient: −0.984, SE: 0.318; p=0.002) and a shorter ED-LOS (coefficient: −3.021, SE: 0.256; p<0.001). There were no significant differences in the 10-day or 30-day readmission rates (p=0.974, p=0.965, respectively).Conclusions The AMU hospitalist care model was associated with reductions in IHM, ICU admission rate, LOS and ED-LOS. These findings suggest that the AMU hospitalist care model has the potential to be adopted into other healthcare systems to improve care for patients with acute medical needs.