Pediatric hospitalists: quality care for the underserved?

Area of Science:

• Pediatric hospital medicine
• Health services research

Background:

• Pediatric hospitalist services are expanding rapidly.
• Empirical data on their impact is limited.

Purpose of the Study:

• To compare process and outcome variables for pediatric patients cared for by hospitalists versus primary care providers (PCPs).
• To assess the impact of hospitalist care on cost-effectiveness, patient safety, and satisfaction.

Main Methods:

• Retrospective comparison of 182 pediatric inpatients.
• Half received care from hospitalists, half from PCPs.
• Analysis of process and outcome variables including cost, readmissions, follow-up, and patient satisfaction.

Main Results:

• Hospitalists managed patients of lower socioeconomic status.
• More economical care was delivered for asthma patients by hospitalists.
• No significant differences in emergency room returns or rehospitalizations were observed.
• Equivalent follow-up rates with PCPs and similar health status at 1 month post-discharge.
• Hospitalist patients reported higher satisfaction with care.

Conclusions:

• Pediatric hospitalists can provide quality inpatient care, particularly for low-income children.
• Hospitalist care is associated with improved patient satisfaction and cost-effectiveness in specific conditions like asthma.
• No negative impact on patient safety or continuity of care was identified.