Better medical care quality in weekday daytime schedule with gastrointestinal hospitalists than conventional care teams

ABSTRACT

Objectives

This study sought to uncover whether having a gastrointestinal (GI) hospitalist available during weekday daytime hours results in higher-quality medical care compared to care provided by a team of residents.

Methods

Our hospitalist GI team consisted of two gastroenterologists working weekday daytime hours and two physician assistants. The team of conventional care headed by thirteen professors, comprised twelve residents and eight physician assistants. We conducted a retrospective cohort study in South Korea between March 2 and December 9, 2020 The hospitalist team treated 528 patients, while the conventional care team treated 2,335. We assessed the medical parameters of length of stay (LOS), rates of in-hospital mortality, transfer to the intensive care unit, and readmission rate within 30 days. Furthermore, we gathered feedback from nurses working with both teams.

Results

The study found that there was no significant difference in LOS between infections (P = 0.422) and other GI diseases like bleeding (P = 0.226). There was no significant difference in the rates of in-hospital mortality (P = 0.865) and transfer to the intensive care unit (P = 0.486) between the two teams. However, the hospitalist team had notably lower readmission rates than the conventional care team (P = 0.002) as well as a lower unscheduled readmission rate (P = 0.046). Furthermore, the survey results indicated that nurses who worked with the hospitalist team had significantly better responses than those who worked with the conventional care team (P < 0.001).

Conclusions

This study indicates that having GI hospitalists work weekday daytime hours improves patient care, and treatment and reduces readmission rates.

KEYWORDS:

• Hospitalist
• gastrointestinal
• schedule
• readmission
• care

Acknowledgments

We sincerely thank Editage (www.editage.com) for their assistance in providing English language editing services.

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

This project was a collective undertaking, and all authors made significant contributions. The author, Hannah Ra, spearheaded the manuscript writing and statistical analyses. Hye Young Lee, Dong Kyun Park, and Oh Sang Kwon researched the design and analyzed the data. They also offered crucial insights that further refined the manuscript. Yoon Jae Kim’s expert supervision was instrumental in ensuring the project’s timely and successful completion.

Data availability statement

The data used in this study are patients’ personal information and cannot be made publicly available. The author may be contacted for submission of reasonable requests.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/21548331.2023.2277676.

Additional information

Funding

This work was supported by the Korean Society of Hospital Medicine under Grant KSHM-2021-001 and by the Gachon University Gil Medical Center (Grant number: FRD2021-21). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.