More internists becoming hospitalists

The percentage of all medical claims by hospitalists for admitted patients more than quadrupled over a decade, a report shows.

By Brian Hedger — Posted April 16, 2009

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The percentage of general internists who are hospitalists tripled from 1995 to 2006, an indication of the continued growth in hospitalist care.

The figure increased from 5.9% in 1995 to 19% in 2006, according to a study in the March 12 New England Journal of Medicine. For the study, researchers defined a hospitalist as a general internist who generated 90% or more of his or her Medicare claims from care of hospitalized patients.

The study also said the percentage of all claims for inpatient care by hospitalists had expanded from 9.1% in 1995 to 37.1% in 2006.

"This [study] shows there is more co-management of patients," said Yong-Fang Kuo, PhD, the study's lead author and associate professor in the Dept. of Internal Medicine at the University of Texas Medical Branch in Galveston. "Traditional, office-based general internists' admissions have probably become less because they know there are more hospitalists available. For some doctors, it's more efficient to let hospitalists care for those patients."

The study said cost savings for hospitals and improved career stability for hospitalists are factors in the continued increase of hospitalists since the mid-1990s. The Society of Hospital Medicine, which represents hospitalists, said about 28,000 hospitalists practice in the United States. The society said studies show that hospitalists decrease patient lengths of stay, and reduce hospital costs and readmission rates.

With the increase in hospitalists, Kuo said, cooperation between primary care physicians and hospitalists becomes crucial for patients.

"Continuity of care may be a problem," she said. "Unless the PCP shares the information on the patient's chart with hospitalists, that relationship between the doctor and their patient would be broken. Sharing information is the way to make for a better transition."

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