Providing hospitalist service 24 hours a day and seven days a week showed better clinical results than offering the service only on weekdays, a study showed.
Professor Han Seung-jun of the Internal Medicine at the Seoul National University Hospital and his colleagues compared the clinical outcomes of 513 hospitalized patients between weekday-only and 24-hour/7-day hospitalist systems, and published the results in the latest issue of the Journal of Korean Medical Science. A hospitalist refers to a specialist who resides in a hospital to take care of hospitalized patients.
The nation started a pilot hospitalist system in 2016, as the new legal limit of working hours of physician trainees reduced the medical workforce, and safety issues with inpatient care emerged.
Only a small number of hospitals run a hospitalist-based model that covers weekend and night duties. At SNUH, five exclusive professors at the hospitalist medicine center are providing patient care 24 hours a day and seven days a week.
The research team classified 275 patients admitted to the SNUH’s internal medicine ward from March to October 2019 as the weekday group. The other 238 patients who were hospitalized during the same period in 2018 were grouped as the 24/7 group.
SNUH initially ran the 24/7 hospitalist service model. However, from March to October 2019, the hospitalist system was available only during weekdays. Thus, the researchers could compare the two models directly.
The researchers found that the 24/7 coverage model showed improved clinical outcomes than the weekday model.
The intensive care unit's admission rate under the 24/7 model was 0.4 percent, much lower than 2.9 percent of the weekday model.
Discharges to local hospitals were more frequent in the full-time group (12.6 percent) than in the weekday group (5.8 percent).
After adjusting for variants, the in-ward mortality risk was about two times higher in the weekday group than the full-time group,
“Uninterrupted weekend coverage hospitalist service can contribute to guaranteed safety of inpatients and appropriate distribution of medical resources,” Han said. “To advance the local hospitalist care, we need to establish a reasonable reimbursement system.”
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