Lee Kheng Hock
Department of Family Medicine & Continuing Care, Singapore General Hospital, Singapore.
Ann Acad Med Singap. 2008 Feb;37(2):145-50.
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.
医疗保健日益复杂，正在加速医学专业化的进程，这反过来又加剧了医院护理的碎片化。医院医师运动主张让全科医生重返医院，为住院患者提供全面且更具整体性的医疗服务。这可被视为对护理碎片化的一种适应性反应。自20世纪90年代中期起，在医疗保健复杂性和碎片化影响最为广泛的北美地区，医院医师运动逐渐壮大，并迅速在整个大陆蔓延开来。本文考察了美国、加拿大和新加坡的医院医师运动现象。结论是，随着医疗保健系统适应推动医疗保健日益复杂的共同全球趋势，医院医师运动的变体可能会在世界不同地区出现。
