Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, USA.
J Hosp Med. 2009 Nov;4(9):528-34. doi: 10.1002/jhm.529.
Hospital medicine has grown rapidly, but hospital leaders' perceptions of current and future drivers of hospitalist growth are unknown.
: To determine hospital executives' perceptions of factors leading to hospitalist implementation and their vision for hospitalists' work roles.
Nonfederal, acute care hospitals in California.
California hospital leaders (eg, chief executive officers).
Cross-sectional survey from 2006 to 2007.
We asked California hospital leaders whether their hospitals had a hospitalist service and the prospects for growth. In addition, we examined factors responsible for implementation, scope of hospitalists' practices, and need for additional certification as perceived by hospital leaders.
We received surveys from 179 of 334 hospitals (response rate of 54%). Of the 64% of respondents that reported the use of hospitalists, none intended to decrease the size of their hospitalist group, and 57% expected growth over 2 years. The most common reasons for implementing a hospitalist program were to care for uncovered patients (68%) and improve cost/length of stay (63%). Respondents also indicated that demand from other physicians was an important factor. Leaders reported that hospitalists provide a wide range of services, with a majority involved in quality improvement projects (72%) and medical comanagement of surgical patients (66%). Most leaders favor additional certification for hospitalists.
There is widespread adoption of hospitalists in California hospitals, with an expectation of continued growth. The drivers of the field's growth are evolving and dynamic. In particular, attentiveness to quality performance and demand from other physicians are increasingly important reasons for implementation.
医院医学发展迅速，但医院领导对目前和未来推动医院医生增长的因素的看法尚不清楚。
确定医院管理人员对导致医院医生实施的因素的看法，以及他们对医院医生工作角色的看法。
加利福尼亚州的非联邦急症护理医院。
加利福尼亚州的医院领导（如首席执行官）。
2006 年至 2007 年的横断面调查。
我们询问了加利福尼亚州的医院领导，他们的医院是否有医院医生服务以及增长的前景。此外，我们还研究了实施的原因、医院医生实践的范围以及医院领导认为需要额外认证的因素。
我们从 334 家医院中的 179 家收到了调查（回应率为 54%）。在报告使用医院医生的 64%的受访者中，没有人打算减少其医院医生团队的规模，而 57%的人预计在 2 年内会有所增长。实施医院医生计划的最常见原因是照顾未覆盖的患者（68%）和改善成本/住院时间（63%）。受访者还表示，来自其他医生的需求是一个重要因素。领导者报告说，医院医生提供了广泛的服务，其中大多数参与质量改进项目（72%）和外科患者的医疗共管（66%）。大多数领导者赞成为医院医生提供额外的认证。
加利福尼亚州的医院广泛采用了医院医生，预计将继续增长。该领域增长的驱动力正在不断发展和变化。特别是，对质量表现的关注和来自其他医生的需求是实施的越来越重要的原因。
