Health Services Research & Development

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2006 HSR&D National Meeting Abstract


2006 — Hospitalists: Review of Research, Current Trends, and Research Opportunities in VA

Author List:
Kaboli PJ (Iowa City VAMC (CRIISP))
Rosenthal GE (Iowa City VAMC (CRIISP))

Objectives:
In recent years, hospitalist programs have appeared in many academic centers and community hospitals and are beginning to emerge in VHA. The growth of hospitalist medicine was largely driven by the belief that hospitalists could reduce costs and maintain or improve quality. While early single-site studies confirmed this belief, a recently completed multi-site study found that differences between hospitalists and non-hospitalists had evaporated. These new findings raise important questions about the effectiveness and value of hospitalist programs for VHA. The objectives of the workshop are to: 1. Review prior research assessing the impact of hospitalists on clinical care. Dr. Peter Kaboli, a principal investigator in the recent AHRQ-funded Multi-Center Trial of Academic Hospitalists, will review prior published studies and preliminary unpublished results from the AHRQ-funded trial. (25 minutes) 2. Identify factors that may have led to discrepancies between the AHRQ trial and earlier studies. Dr. Gary Rosenthal will review factors related to the organization of hospitalist programs and methodological issues that might explain the diminished impact of hospitalists in the recent AHRQ trial. (15 minutes) 3. Evaluate the current trends in the use of hospitalists in VA. Dr. Kaboli will present preliminary data from a VA survey to identify the prevalence of hospitalists in VHA and organization of hospitalist services. (20 minutes) 4. Discuss future research questions and opportunities in hospital-based research in VA. Drs. Rosenthal and Kaboli will lead a discussion of opportunities for research in VHA in inpatient care, and opportunities for building a collaborative multi-site research network to evaluate, in an ongoing manner, variations in the organization of hospitalist programs and impact of this variation. (30 minutes)

Methods:
The workshop will combine didactic and discussion formats with active audience participation in each of the segments. The workshop leaders will actively solicit participants’ experiences with hospitalist programs. The workshop will solicit interest among participants in establishing a practice-based research network focusing on inpatient care.

Results:
VA researchers, clinicians, and/or administrators with interests in research involving acute medical patients and the role of hospitalist.

Implications:
The audience can have any level of familiarity with the topic and gain from the workshop.

Impacts: