Characteristics of primary care providers who adopted the hospitalist model from 2001 to 2009. Issue 2 (February 2015)

• Record Type: Journal Article
• Authors: Boonyasai, Romsai T.; Lin, Yu‐Li; Brotman, Daniel J.; Kuo, Yong‐Fang; Goodwin, James S.
• Is Part Of: Journal of hospital medicine. Volume 10:Issue 2(2015)
• Page Start: 75
• Page End: 82
• Publication Date: 2015-02
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.1002/jhm.2269
• Languages: English
• ISSNs: 1553-5592

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jhm2269-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The characteristics of primary care providers (PCPs) who use hospitalists are unknown.</p> </sec> <sec id="jhm2269-sec-0002" sec-type="section"> <title>METHODS</title> <p>Retrospective study using 100% Texas Medicare claims from 2001 through 2009. Descriptive statistics characterized proportion of PCPs using hospitalists over time. Trajectory analysis and multilevel models of 1172 PCPs with ≥20 inpatients in every study year characterized how PCPs adopted the hospitalist model and PCP factors associated with this transition.</p> </sec> <sec id="jhm2269-sec-0003" sec-type="section"> <title>RESULTS</title> <p>Hospitalist use increased between 2001 and 2009. PCPs who adopted the hospitalist model transitioned rapidly. In multilevel models, hospitalist use was associated with US training (odds ratio [OR] 1.46, 95% confidence interval [CI]: 1.23‐1.73 in 2007–2009), family medicine specialty (OR: 1.46, 95% CI: 1.25‐1.70 in 2007–2009), and having high outpatient volumes (OR: 1.32, 95% CI: 1.20‐1.44 in 2007–2009). Over time, relative hospitalist use decreased among female PCPs (OR: 1.91, 95% CI: 1.46‐2.50 in 2001–2003; OR: 1.50, 95% CI: 1.15‐1.95 in 2007–2009), those in urban locations (OR: 3.34, 95% CI: 2.72‐4.09 in 2001–2003; OR: 2.22, 95% CI: 1.82‐2.71 in 2007–2009), and those with higher inpatient volumes (OR: 1.05, 95% CI: 0.95‐1.18 in 2001–2003; OR: 0.55, 95% CI: 0.51‐0.60 in 2007–2009). Longest‐practicing PCPs were more likely to transition in the early 2000s, but this effect disappeared by the end of the study period (OR: 1.35, 95% CI: 1.06‐1.72 in 2001–2003; OR: 0.92, 95% CI: 0.73‐1.17 in 2007–2009). PCPs with practice panels dominated by patients who were white, male, or had comorbidities are more likely to use hospitalists.</p> </sec> <sec id="jhm2269-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>PCP characteristics are associated with hospitalist use. The association between PCP characteristics and hospitalist use has evolved over time. <italic>Journal of Hospital Medicine</italic> 2015;10:75–82. © 2015 Society of Hospital Medicine</p> </sec> </abstract>