Monday, December 08, 2014

Management of febrile neutropenia: Do hospitalists add value?

This study, which showed improved care processes and decreased mortality during a gradual increase in hospitalist care of these patients, will probably be cited by the boosters of hospital medicine as another example of added value. However, as the authors themselves pointed out, the improved outcomes are more likely the result of secular trends.

The full text of the paper is worth reading because it describes what I'll call the second wave of increased utilization of hospitalists, that is, hospitalists increasingly acting as the primary attending for subspecialty patients. In the large health care system reported in the referenced paper subspecialists had almost entirely turned their admissions over to hospitalists by the end of the study period.

Across all the subspecialties do hospitalists do a better job? Research to date does not indicate that they do, but more studies are needed.

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