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Comparisons of Clinical Outcomes between Weekday-Only and Full-Time, 24-Hour/7-Day Coverage Hospitalist Systems

Journal of Korean Medical Science 2020년 35권 18호 p.117 ~ 117
한승준 ( Han Seung-Jun ) - Seoul National University Hospital Department of Internal Medicine

정희원 ( Jung Hee-Won ) - Seoul National University Hospital Department of Internal Medicine
오도연 ( Oh Do-Youn ) - Seoul National University Hospital Department of Internal Medicine
이재현 ( Lee Jae-Hyun ) - Seoul National University Hospital Department of Internal Medicine
 ( Moon Sung-Do ) - Seoul National University Hospital Department of Internal Medicine
이선혜 ( Lee Sun-Hye ) - Seoul National University Hospital Department of Internal Medicine
윤정환 ( Yoon Jung-Hwan ) - Seoul National University Hospital Department of Internal Medicine

Abstract


Background: Since the launch of pilot programs in 2016, varying ranges of hospitalist coverage exist in Korea. We evaluated the effects of differing depths of hospitalist coverage on clinical outcomes.

Methods: This study retrospectively reviewed the records of 513 patients admitted to a medical hospitalist unit through emergency department at Seoul National University Hospital. The full-time group included patients admitted in 2018 who received 24/7 hospitalist service, whereas the weekday group included patients admitted in 2019 with only weekday hospitalist service. In-hospital clinical outcomes were compared between the two groups.

Results: Unplanned intensive care unit admission rate was lower in the full-time group than in the weekday group (0.4% vs. 2.9%; P = 0.042). Discharges to local hospitals for subacute or chronic care were more frequent in the full-time group than in the weekday group (12.6% vs. 5.8%; P = 0.007). The weekday coverage was a predictive factor of in-ward mortality (odds ratio, 2.00; 95% confidence interval, 1.01?3.99) after adjusting for potential confounding factors.

Conclusion: Uninterrupted weekend coverage hospitalist service is helpful for care-plan decision and timely care transitions for acutely and severely ill patients.

키워드

Hospitalists; Hospital Medicine; Mortality; Length of Stay
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