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词条 Post-hospitalist
释义

  1. History

  2. Training

  3. Quality

  4. See also

  5. References

  6. External links

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Post-Hospitalist Medicine is the discipline concerned with the medical care of post-acute patients. Physicians whose primary professional focus is post-hospital care are post-hospitalists.

Typical community PCPs and most other NP/PA/extender models do not have the time or ability to effectively monitor patient care when the patient is in a post-acute facility. As a result, increased hospitalizations, readmissions and unnecessary ER utilization occur frequently, increasing overall health care costs.[1] When patients become ill with an urgent or non-emergency problem, most traditional care models typically direct the patient to the ER, utilizing the ER as an outpatient clinic rather than going to the post-acute facility, examining and treating the patient on-site.[2]

By comparison, other models providing limited results and exposure to facilities include the following:

  • Traditional attending physicians (PCPs) and/or medical directors
  • NP practices – Independent NPs provide post-acute rounding services on behalf of collaborative physicians
  • Group practice extenders – Employed extenders of traditional practices provide post-acute rounding services.
  • Hospitalist extenders – Employed extenders of hospitalist programs provide post-acute rounding services.
  • Health system extenders – Employed extenders of hospitals/health systems provide post-acute rounding services.

Post-hospitalist medical services focus on providing better care to meet the needs of high-risk, medically complex patients with the following common diagnoses:

  • Asthma
  • Major Depressive Disorder
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Osteoporosis
  • Congestive Heart Failure (CHF)
  • End Stage Renal Disease
  • Dehydration
  • Hepatitis C
  • Pneumonia
  • Hypertension
  • Urinary Tract Infections (UTI)
  • Rheumatoid Arthritis
  • Diabetes Mellitus
  • Pre and/or Postoperative Care
  • Coronary Artery Disease
  • Medication Reconciliation

In many instances, this population of patient has multiple diagnoses, co-morbidities and their medical needs are extensive.

In the past, these patients would have stayed in the hospital much longer and at much higher overall health care costs. Today, managing their care in less costly post-acute settings such as LTACs, Rehab Centers, Skilled Nursing and Long-Term Care Facilities is possible with the use of Post-Hospitalist Medical Services being provided on-site in these settings. Post Hospitalists provide these specialized medical services exclusively in these various types of post-acute facilities.[3]

History

The term post-hospitalist was first attributed to Thomas Prose, MD, MPH, MBA, who coined the term in 2012. Prose founded General Medicine P.C.—a health care practice devoted to the practice of post-hospitalist medicine in 1983. The practice of post-hospitalist medicine is still new in the United States and—while it has not yet reached widespread adoption—is one of the faster growing of medical specialties.[4]

Training

As a relatively new specialty, only recently has certification for specialty experience and training for hospital medicine been offered. The American Board of Hospital Medicine (ABHM), a Member Board of the American Board of Physician Specialties (ABPS), was founded in 2009. The ABHM was North America’s first board of certification devoted exclusively to hospital medicine. In September 2009, the American Board of Internal Medicine (ABIM) created a program that provides general internists practicing in hospital settings the opportunity to maintain Internal Medicine Certification with a Focused Practice in Hospital Medicine (FPHM).

Quality

Research shows that hospitalists reduce the length of stay, treatment costs and improve the overall efficiency of care for hospitalized patients. Post-hospitalists are leaders on several quality improvement initiatives in key areas including transitions of care, co-management of patients, reducing hospital acquired diseases and optimizing the care of patients.

See also

  • Society of Hospital Medicine
  • Hospitalist

References

1. ^http://www.slideshare.net/GeneralMedicine/why-hospital-readmissions-from-nursing-homes-dont-matter Why Hospital Readmissions from Nursing Homes Don’t Matter
2. ^http://www.amednews.com/article/20080128/profession/301289967/7/ Study ties hospitalist care to shorter patient stays, American Medical News by the American Medical Association
3. ^http://www.nejm.org/doi/full/10.1056/NEJMe078208 The Hospitalist Movement — Time to Move On, New England Journal of Medicine
4. ^https://www.researchgate.net/publication/265014190_9_of_the_top_10_MCOs_in_the_U.S._Have_Contracted_With_The_Post-Hospitalist_Company_General_Medicine 9 of the top 10 MCOs in the U.S. Have Contracted With The Post-Hospitalist Company, General Medicine

External links

  • American Board of Hospital Medicine
  • Society of Hospital Medicine
  • American Board of Internal Medicine
  • [https://www.generalmedicine.com General Medicine, P.C.]
  • Why Hospital Readmissions from Nursing Homes Don’t Matter, Slideshare
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1 : Healthcare in the United States

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