No abstract available.
Hospitalists* ; Humans ; Korea*

No abstract available.
Hospitalists ; Humans ; Korea

The increasing complexity of healthcare is accelerating the rate of specialisation in medicine, which in turn aggravates the fragmentation of care in hospitals. The hospitalist movement advocates for the return of generalist physicians to the hospital to provide general and more holistic medical care to inpatients. This can be seen as an adaptive response to care fragmentation. Starting in the mid-1990s in North America, where the impact of healthcare complexity and fragmentation has been most widely felt, the hospital movement has gained strength and spread across the continent rapidly. This paper examines the phenomenon of the hospitalist movement in the United States, Canada and Singapore. The conclusion is that variants of the hospital movement may emerge in different parts of the world as healthcare systems adapt to common global trends that drive the increasing complexity of healthcare.
Australia ; Diffusion of Innovation ; Hospitalists ; trends ; Hospitals ; Singapore ; United States

A hospitalist system in Korea began in August 2016. Patient safety issues, resident law, and reduction of resident numbers in Korea are leading to an increase in the demand for hospitalist in Korea. The roles and responsibilities of GI hospitalists have not been established. Therefore, cooperation among the Korean society of gastroenterology, each hospital, and government is necessary. In particular, it is important to prepare an education program for gastroenterology hospitalists.
Education ; Gastroenterology ; Hospitalists ; Humans ; Inpatients ; Jurisprudence ; Korea ; Patient Safety

A hospitalist system in Korea began in August 2016. Patient safety issues, resident law, and reduction of resident numbers in Korea are leading to an increase in the demand for hospitalist in Korea. The roles and responsibilities of GI hospitalists have not been established. Therefore, cooperation among the Korean society of gastroenterology, each hospital, and government is necessary. In particular, it is important to prepare an education program for gastroenterology hospitalists.
Education ; Gastroenterology ; Hospitalists ; Humans ; Inpatients ; Jurisprudence ; Korea ; Patient Safety

A gap in the number of physicians caring for inpatients is expected in 2014 based on the restricted working hours for Korean medical residents. One potential solution is the use of hospitalists. The US hospitalist movement has proliferated due to high-quality care and economics. This movement has brought positive changes including a shorter length of hospital stay, increased quality of care, and greater patient satisfaction. Because the Korean government controls all suppliers and maintains a low financial compensation level for universal coverage, hospitals do not have the financial resources to introduce hospitalists. Therefore, in contrast to the US, the use of hospitalists must be developed as a cost-compensated system in Korea. Institutional strategies must be introduced to develop a hospitalist system in Korea. A hospitalist system in Korea would be distinct from that in the US. Further studies and specific strategies are needed that consider Korea's circumstances to effectively introduce a hospitalist system.
Compensation and Redress ; Hospital Medicine ; Hospitalists* ; Humans ; Inpatients ; Korea ; Length of Stay ; Patient Satisfaction ; Universal Coverage

A hospitalist-run acute medical unit (AMU) opened at a tertiary care hospital on August 2015 for the first time in Korea. Patients visiting the emergency department (ED) with acute medical problems are admitted to the AMU. They stay in that unit for less than 72 hours and are discharged or transferred to specialty wards if longer treatment is necessary. We reviewed 19,450 medical admissions through the ED from January 2014 to September 2016. The median length of stay (LOS) significantly decreased from 10.0 days (interquartile range [IQR], 5.5–16.7) to 9.1 days (IQR, 5.1–15.0) (P < 0.001) after the establishment of the AMU. The median waiting time in the ED significantly shortened by 40% (P < 0.001). Future studies on the impact of AMU on in-patient morbidity, mortality, re-admission rate, and patient or staff satisfaction are necessary.
Emergencies* ; Emergency Service, Hospital* ; Hospital Medicine ; Hospitalists ; Humans ; Korea ; Length of Stay* ; Mortality ; Tertiary Healthcare*

The Korean hospitalist system was introduced in 2016. The new inpatient care system that provides direct care from a specialist required great efforts from various parties to implement successfully. This study outlines the implementation of the Korean hospitalist system and the development strategies based on pilot studies. The definition of the Korean hospitalist includes two elements which are 1) hospitalist is a physician who is in charge of a patient from admission to discharge and 2) hospitalist should stay in the hospitalist ward, where a hospitalist provides medical services to patients at their point of needs. The purpose of the Korean hospitalist system is to provide high-quality care and to ensure the safety of admitted patients. Due to a gap in the healthcare workforces in hospitals caused by changes in the residents' working hours and training period of the residents, the implementation of a new system was inevitable to provide care for patients. The result of private and public pilot studies indicated that hospitals, physicians, and patients are keen to have the hospitalist system in place. Also, those stakeholders agreed that reasonable and accurate fee-schedules for hospitalist services would enhance the service system. Within the current system, hospitals are reimbursed for providing the service, while patients pay out-of-pocket. Therefore, the service can only be applied to a patient who agrees to pay the additional fee for the service. As the Korean medical system is facing a paradigm shift, the Korean hospitalist system will play an essential role in the transition as moving forward to provide professional care for inpatients.
Delivery of Health Care ; Fees and Charges ; Hospitalists ; Humans ; Inpatients ; Patient Safety ; Pilot Projects ; Specialization

A resident is a preliminary specialist with a medical license. It is also the status of an employee at a training hospital who is trained by clinical faculty. This duality makes the role of a resident unique, because its interpretation differs dramatically depending on whether one focuses on a resident's status as a trainee or as an employee. Issues regarding patient safety have emerged as residents have come to emphasize their role as employees in discussions of how to balance their work duties with their learning responsibilities. The workload that was taken for granted is no longer considered natural. Two years have elapsed since the enactment of the resident law, which was passed to improve the training environment and working conditions of residents, and limits them to 80 hours of work per week. However, confusion persists in the field. In order to solve problems regarding resident education, new education program with hospitalists and the financial and administrative support from hospitals and the government are important.
Education ; Financing, Organized ; Hospital Medicine ; Hospitalists ; Humans ; Internship and Residency ; Jurisprudence ; Learning ; Licensure ; Patient Safety ; Specialization

Recent changes in the Korean government's strategies for resident quotas and training condition results is creating a gap in the treatment of inpatients and threatening patient safety. The hospitalist system, which has been established and operates in the United States, has also been suggested as an alternative in Korea. In 2015, a pilot project for the implementation of a hospitalist system was successfully executed in three teaching hospitals. The most important factors for the successful implementation of a hospitalist system are to establish the job description and security of the hospitalist. In addition, securing finances and making medical insurance fee-for-service, a certification system for hospitalists, an education program, and proper salaries are needed. The introduction and management of a hospitalist system may be seen as necessary for the times, considering changing resident strategies and the reinforcement of responsibility for patient safety. The hospitalist system is a solution for the gap in the treatment of inpatients and is predicted to improve patient safety.
Certification ; Education ; Hospitalists* ; Hospitals, Teaching ; Humans ; Inpatients ; Insurance ; Job Description ; Korea ; Patient Safety ; Pilot Projects ; Salaries and Fringe Benefits ; United States