Freeman William D, Gronseth Gary, Eidelman Benjamin H
Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Neurology. 2008 Apr 8;70(15):1282-8. doi: 10.1212/01.wnl.0000308949.45423.13. Epub 2008 Mar 12.
Explosive growth of hospital-based medicine specialists, termed hospitalists, has occurred in the past decade. This was fueled by pressures within the American health care system for timely, cost-effective, and high-quality care and by the growing chasm between inpatient and outpatient care. In this article, we sought to answer five questions: 1) What is a neurohospitalist? 2) How many neurohospitalists practice in the United States? 3) What are potential advantages of neurohospitalists? 4) What are the challenges of implementing a neurohospitalist practice? 5) What effect does a neurohospitalist have on clinical outcomes?
We queried biomedical databases (e.g., PubMed) by using the search terms "hospitalist," "neurohospitalist," and "neurology hospitalist." We also searched the Society of Hospital Medicine and the American Academy of Neurology Dendrite classified advertisement Web sites for hospitalist and neurology hospitalist growth by using the same search terms.
We defined neurology hospitalists (neurohospitalists) as neurologists who devote at least one-quarter of their time managing inpatients with neurologic disease. Although the number of hospitalists has grown considerably over the past decade, limited data on neurohospitalists exist. Advertisements for neurohospitalist positions have increased from 2003 through 2007, but accurate assessment of growth is limited by the lack of a central organizational affiliation and unifying terminology.
Health care pressures spawned the growth of medicine and pediatric hospitalists, who provide efficient, cost-effective care by reducing the length of hospitalization. Because neurologists experience the same pressures, we expect neurohospitalists to increase in number, especially within areas that have sufficient inpatient volume and resources.
在过去十年中，以医院为基础的医学专科医生（即住院医师）数量呈爆炸式增长。美国医疗保健系统对及时、具成本效益且高质量医疗的压力，以及住院治疗与门诊治疗之间日益扩大的差距推动了这一增长。在本文中，我们试图回答五个问题：1）什么是神经科住院医师？2）美国有多少神经科住院医师？3）神经科住院医师有哪些潜在优势？4）实施神经科住院医师制度面临哪些挑战？5）神经科住院医师对临床结果有何影响？
我们使用“住院医师”“神经科住院医师”和“神经内科住院医师”等搜索词查询生物医学数据库（如PubMed）。我们还使用相同的搜索词在医院医学协会和美国神经病学学会Dendrite分类广告网站上搜索住院医师和神经内科住院医师的增长情况。
我们将神经内科住院医师（神经科住院医师）定义为至少将四分之一的时间用于管理神经系统疾病住院患者的神经科医生。尽管在过去十年中住院医师数量大幅增长，但关于神经科住院医师的数据有限。2003年至2007年，神经科住院医师职位的招聘广告有所增加，但由于缺乏中央组织隶属关系和统一术语，对其增长的准确评估受到限制。
医疗保健压力催生了内科和儿科住院医师的增长，他们通过缩短住院时间提供高效、具成本效益的医疗服务。由于神经科医生也面临同样的压力，我们预计神经科住院医师的数量将会增加，尤其是在住院患者数量和资源充足的地区。
