Comparisons of Clinical Outcomes between Weekday-Only and Full-Time, 24-Hour/7-Day Coverage HospitalistSystems
10.3346/jkms.2020.35.e117
- Author:
Seung Jun HAN
1
;
Hee-Won JUNG
;
Do-Youn OH
;
Jae Hyun LEE
;
Sung do MOON
;
Sunhye LEE
;
Jung-Hwan YOON
Author Information
1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Publication Type:Original Article
- From:Journal of Korean Medical Science
2020;35(18):e117-
- CountryRepublic of Korea
- Language:0
-
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.
