[Hospitalist Model Implementation in a Chilean Medical Service: Eight Years of Diagnosis-Related Group Indicators]

The implementation of the hospitalist model (HM) in public hospitals across Latin America has been scarcely documented. In Chile, the Diagnosis-Related Groups (DRG) system enables standardized analysis of hospital performance; however, its longitudinal behavior in the context of organizational reform remains underexplored.

To describe historical trends in DRG-based indicators of productivity and morbidity-mortality in the Internal Medicine Service (IMS) of Hospital Las Higueras de Talcahuano (HHT) from 2012 to 2019, during the progressive implementation of the hospitalist model.

A retrospective, observational, and descriptive study was conducted using the full set of hospital discharges from IMS-HHT coded by DRG. Two operationally defined periods were compared: P1 (2012-2016, traditional care model) and P2 (2016-2019, hospitalist model implementation). Four indicator domains were analyzed: general, process, complexity, and outcomes. Due to the population-based nature of the data, no statistical tests for significance were applied.

IMS accounted for 13.8% to 17.5% of total HHT discharges. During P2, an increase in the average DRG weight and in the proportion of severe cases was observed. The adjusted length-of-stay index (ALOSi) initially rose and then steadily declined from the third year onward. Urgent readmissions and hospital mortality rates consistently decreased starting from the beginning of P2.

The temporal evolution of DRG indicators suggests a pattern of sustained improvement in clinical and administrative performance during the implementation of the hospitalist model, without inferring causal relationships.