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Robert M. Centor, MD

Arch Intern Med. 2008;168(12):1257-1258.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

What is a hospitalist inpatient system? How do we define improving patient care outcomes (PCOs)? To what alternative are we comparing a hospitalist inpatient system?

We have been asked to debate a proposition that raises many questions. I submit that per se a hospitalist inpatient system does not improve PCOs. I will base my argument on several major points.

DEFINING HOSPITALIST SYSTEMS

First, hospitalist "systems" vary greatly among hospitals. We cannot evaluate hospitalist systems generically because of their great variation. Second, we must look at all outcomes. We cannot focus just on hospital outcomes; we must include long-term outcomes. The hospitalist model might have positive or negative effects on trust and satisfaction. Third, we must consider the relative importance of physician factors and system factors. We must include continuity factors—both in the hospital and across settings.

The first explicit discussion of the job description hospitalist came in the classic . . . [Full Text of this Article]

DEFINING PCOs

REDEFINING THE QUESTION

FOCUSING OUR EFFORTS

AUTHOR INFORMATION

Author Affiliation: Department of Internal Medicine, University of Alabama, Birmingham.

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