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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Evaluation of a staff-only hospitalist system in a tertiary care, academic children's hospital.
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Evaluation of a staff-only hospitalist system in a tertiary care, academic children's hospital.

机译：对三级护理学龄儿童医院中仅由工作人员组成的住院医生系统的评估。

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OBJECTIVE: The staff/housestaff hospitalist system has been evaluated in 2 pediatric centers in the United States. In Canada, fewer residents and duty hour restrictions led to the development of a staff-only hospitalist system. The objective of this study was to compare the staff-only pediatric hospitalist system and the staff/housestaff hospitalist system with respect to traditional outcome measures. DESIGN: This cohort study (staff-only hospitalist system versus staff/housestaff system) used electronic health records data (July 1, 1996, to June 30, 1997) for all admissions (n = 3807) to the general pediatric inpatient unit of an urban, tertiary care, pediatric, teaching hospital in Toronto, Canada. Outcome measures included length of hospital stay, subspecialty consultations, readmission to the hospital, and death during the hospital stay. RESULTS: The median length of hospital stay was reduced by 14% for patients admitted to the staff-only hospitalist system, compared with the staff/housestaff hospitalist system (2.5 and 2.9 days, respectively). This difference remained statistically significant after adjustment for age, gender, and comorbidity. There were no significant differences between the 2 models of care with respect to subspecialty consultation, hospital readmission, or mortality rates. A stratified analysis showed similar findings for the 10 most frequent diagnostic groups. CONCLUSIONS: The staff-only hospitalist system was associated with a significant reduction in the hospital length of stay, without evidence of adverse effects on mortality or readmission rates, compared with the staff/hospitalist system. In the context of recent restrictions on resident duty hours in the United States, these findings may be of interest to pediatric teaching hospitals considering the development of a similar staff-only hospitalist model.
机译：目的：在美国的两个儿科中心对工作人员/职员医院的住院医生系统进行了评估。在加拿大，较少的居民和工作时间限制导致建立了仅工作人员的住院医生系统。这项研究的目的是比较传统结果测量法的纯员工儿科住院医生系统和员工/收养员工住院医生系统。设计：这项队列研究（仅限员工的医院系统与员工/家庭工作人员系统）使用了电子病历数据（1996年7月1日至1997年6月30日），用于所有普通科小儿住院患者的入院（n = 3807）。加拿大多伦多的城市，三级医疗，儿科，教学医院。结果指标包括住院时间长短，专科咨询，再次入院以及住院期间死亡。结果：与职员/家庭职员住院系统相比，仅由职员住院系统住院的患者的住院时间中位数减少了14％。在对年龄，性别和合并症进行校正后，这种差异在统计学上仍然很显着。在亚专业咨询，住院再入院或死亡率方面，两种护理模式之间没有显着差异。分层分析显示，对于10个最常见的诊断组，发现相似。结论：与员工/医院系统相比，仅员工系统的住院系统与住院时间的显着减少有关，而没有证据表明对死亡率或再入院率有不利影响。考虑到美国最近对居民执勤时间的限制，考虑到发展类似的仅限员工的住院医生模式，这些发现对于儿科教学医院可能是有意义的。

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