Frequently hospitalized patients may benefit from new medical specialty focused on their needs
Declining rates of hospitalization have discouraged primary care doctors from seeing their patients in the hospital and encouraged the growing use of "hospitalists," a new physician specialty focused on the care of hospitalized patients. Further developments in the field mean that frequently hospitalized patients also may need a specialist focused on their care, according to an expert on hospital care at the University of Chicago.
The model defining the role of hospitalists, who practice only in hospitals, was first identified in a 1996 article in the New England Journal of Medicine, said David O. Meltzer, an associate professor of medicine and director of the University of Chicago's Center for Health and the Social Sciences.
"Since that time, hospitalists have become the fastest-growing medical specialty in the United States, providing more than one-third of all general medical care in the United States," Meltzer wrote in the paper, "Coordination, Switching Costs and the Division of Labor in General Medicine: An Economic Explanation for the Emergence of Hospitalists in the United States," published by the National Bureau of Economic Research.
Meltzer discussed the growth of the field as well as the potential need for a new specialty the comprehensive care physician, who would specialize in care of the seriously ill Friday at a conference organized by the Milton Friedman Institute at the University of Chicago. The conference, "Individuals and Institutions in the Health Care Sector," also will look at issues such as technology and insurance.
The hospitalist specialty developed in response to the growing needs of severely ill patients, combined with reduced hospitalization of patients by general care or ambulatory physicians, Meltzer argues. As their number of hospitalized patients declined, general care physicians saw their travel costs loom large compared to the small number of hospitalized patients, Meltzer points out.
The use of hospitalists also has grown as hospitals have changed how they are reimbursed for their services, Meltzer contends. "Though the evidence that hospitalists produce savings is not consistent, it is clear that the growth of hospitalists accelerated as evidence to support cost-savings began to appear in the mid-1990s," he said.
The use of hospitalists has the potential of creating communication problems, however, as these specialists do not always know the full medical histories of their patients as well as those patients' general care physicians. The establishment of a specialty called the comprehensive care physician, or comprehensivist, could overcome that problem, Meltzer contends. The comprehensivist would work both in a hospital and an attached clinic and attend to those at greatest risk of hospitalization.
"Congestive heart failure, end-stage renal disease or liver disease, sickle cell disease or chronic-obstructive pulmonary disease might all be reasonable models for such care, especially if cases could be collected into centers of excellence with sufficient volume to support such degrees of specialization," he said.
Although the comprehensivist model has yet to be introduced in the United States, it is similar to other approaches in Canada, the United Kingdom, Australia and New Zealand, he said.
Provided by
University of Chicago
-
Study shows dramatic growth in number of hospitalists
Mar 11, 2009 |
not rated yet |
0
-
Medicare recipients see declines in continuity of care
Apr 22, 2009 |
not rated yet |
0
-
Benefits of hospitalist care confirmed in new study
Dec 20, 2007 |
not rated yet |
0
-
Hospital software improves patient satisfaction at discharge from hospital
Jul 17, 2009 |
not rated yet |
0
-
How to reduce hospital stays and increase patient satisfaction
Oct 01, 2009 |
not rated yet |
0
-
Motion perception revisited: High Phi effect challenges established motion perception assumptions
Apr 23, 2013 |
3 / 5 (2) |
2
-
Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update)
Apr 02, 2013 |
4.5 / 5 (11) |
5
-
The visual system as economist: Neural resource allocation in visual adaptation
Mar 30, 2013 |
5 / 5 (2) |
9
-
Separate lives: Neuronal and organismal lifespans decoupled
Mar 27, 2013 |
4.9 / 5 (8) |
0
-
Sizing things up: The evolutionary neurobiology of scale invariance
Feb 28, 2013 |
4.8 / 5 (10) |
14
-
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011
- More from Physics Forums - Independent Research
More news stories
New research identifies risks, interventions for children's GI health
An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).
Health
May 18, 2013 |
not rated yet |
0
|
Youth who have their first drink during puberty have higher levels of later drinking
Research shows that the earlier the age at which youth take their first alcoholic drink, the greater the risk of developing alcohol problems. Thus, age at first drink (AFD) is generally considered a powerful predictor of ...
Health
May 17, 2013 |
not rated yet |
0
British MPs concerned about parliamentary boozing
One quarter of British lawmakers believe there is an "unhealthy" drinking culture in the Houses of Parliament, according to a survey published on Friday.
Health
May 17, 2013 |
not rated yet |
0
Patient openness to research can depend on race and sex of study personnel
Researchers at the University of Cincinnati (UC) have found that the race and sex of study personnel can influence a patient's decision on whether or not to participate in clinical research.
Health
May 17, 2013 |
not rated yet |
0
Clinical support for patient self-management is rhetoric rather than reality
The processes to allow people to self-manage their own illness are not being used appropriately by health professionals to the benefit of their patients, new research suggests.
Health
May 17, 2013 |
not rated yet |
0
Researchers identify a potential new risk for sleep apnea: Asthma
Researchers at the University of Wisconsin have identified a potential new risk factor for obstructive sleep apnea: asthma. Using data from the National Institutes of Health (Heart, Lung, and Blood Institute)-funded Wisconsin ...
Study finds that sleep apnea and Alzheimer's are linked
A new study looking at sleep-disordered breathing (SDB) and markers for Alzheimer's disease (AD) risk in cerebrospinal fluid (CSF) and neuroimaging adds to the growing body of research linking the two.
'Gap' for HIV vaccine efforts after latest setback
The hunt for an HIV vaccine has gobbled up $8 billion in the past decade, and the failure of the most recent efficacy trial has delivered yet another setback to 26 years of efforts.
Computational tool translates complex data into simplified 2-dimensional images
In their quest to learn more about the variability of cells between and within tissues, biomedical scientists have devised tools capable of simultaneously measuring dozens of characteristics of individual ...
New theory on genesis of osteoarthritis comes with successful therapy in mice
Scientists at Johns Hopkins have turned their view of osteoarthritis (OA) inside out. Literally. Instead of seeing the painful degenerative disease as a problem primarily of the cartilage that cushions joints, ...
Ginger compounds may be effective in treating asthma symptoms
Gourmands and foodies everywhere have long recognized ginger as a great way to add a little peppery zing to both sweet and savory dishes; now, a study from researchers at Columbia University shows purified components of the ...