Respondents report positive impacts of hospitalist programs on quality of care and primary care physician recruitment and retention, but mixed financial impacts. Assessments of the impact of hospitalists in rural hospitals need to take into account the variety of practitioner specialties functioning as hospitalists, the amount of time they spend as hospitalists, and the multiple roles they play in the rural hospital and community. FHCS believes that Home Care is a progressive, alternative to institutionalization; therefore, our company focuses on providing a full range of quality, cost-effective health care services to patients within our service coverage area.
The survey examined reasons for using hospitalists, characteristics of hospitalist practices, and the impacts of hospitalist use in rural settings. Rural hospitals most commonly establish a hospitalist program to address medical staff requests, call coverage, and quality issues.
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Hospitalists may add value by being more available to inpatients, having more hospital experience and expertise, and having an increased commitment to hospital quality improvement compared with primary care providers. Potential disadvantages of the hospitalist model include loss of information as a result of discontinuity of care, patient dissatisfaction, loss of acute care skills by primary care physicians, and burnout among hospitalists. A variety of models of care are needed to meet the clinical, organizational, financial, and political demands of diverse health care systems. The favored model should be that which produces the best clinical outcomes and the highest patient satisfaction at the lowest cost. substantial resources, but even these high costs have not eliminated iatrogenic complications.
We found that hospitals that were financially weak before the recession remained so during and after the recession. The total margins of nonprofit hospitals (both safety-net and other institutions) declined in 2008 but returned to their pre-recession levels by 2011.
The recession did not create additional fiscal pressure on hospitals that were previously financially weak or in safety-net roles. However, both groups continue to have notable financial deficiencies that could limit their abilities to meet the growing demands on the industry. Research on hospitalist programs has primarily focused on large, urban facilities. To fill a gap in the literature on hospitalist use in rural hospitals, the authors conducted a national survey of 402 rural hospitals with 100 or fewer beds that had reported having hospitalists.
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The hospitalist movement, by which a specialized group of physicians cares for inpatients, especially on medical and pediatric services, has reduced costs, generally maintained the satisfaction of all participants, and appears to have improved the quality of care. Despite concerns about discontinuity of care, hospitalists are likely to become the dominant mode of inpatient care in the United States. The recent recession had a profound effect on all sectors of the US economy, including health care. We examined how private hospitals fared through the recession and considered how changes in their financial health may affect their ability to respond to future industry challenges.