J Clin Outcomes Manage
Characteristics of hospitalists and hospitalist programs in the United States and Canada
Soong C, Fan E, Howell EE, Maloney RJ, Pronovost PJ, Wilton D, Wright SM
Abstract Objective: To compare hospitalist physician and program characteristics in the United States and Canada. Design: Cross-sectional study using survey instruments. Measurements: Hospitalist characteristics included age, gender, residency training, international medical graduate status, part-time status, salary, and paid time off. Hospitalist program characteristics included age of program, hospital size, clinical and nonclinical services rendered, teaching activities, on-site night coverage of patients, program growth, and utilization of nurse practitioners, physician assistants, and case managers. Results: American hospitalists were predominantly internal medicine–trained (82%), whereas Canadian hospitalists were trained in family medicine (90%; p < 0.001). American hospitalist groups were more involved with consultative work (98% vs. 59%; p < 0.001), intensive care unit patient care (75% vs. 4%; p < 0.001), rapid response team service (35% vs. 16%; p = 0.01), and surgical inpatient comanagement (84% vs. 57%; p < 0.001). However, American programs provided less pediatric care (12% vs. 31%; p < 0.001) and psychiatric inpatient comanagement (2% vs. 51%; p < 0.001) than programs in Canada. On-site evening coverage of inpatients was more prevalent among American versus Canadian hospitalist groups (51% vs. 30%; p = 0.01). Conclusion: American and Canadian hospitalist physician and program characteristics appear to be different. These differences may allow for future studies to identify strategies and best practices for inpatient care.
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