Hospitalist organizational structures in the Baltimore-Washington area and outcomes: A descriptive study

• Background: Hospitalist groups are heterogeneous and the ideal model for inpatient care is not known. Organizational characteristics of hospitalists may impact outcomes. • Objective: To describe and compare hospitalist groups at 5 hospitals. • Design: Observational retrospective study using survey instruments. • Participants: Hospitalist program leaders. • Measurements: Characteristics collected include hospital volume and size; hospitalist age, gender, years in practice, board certification status, international medical graduate status, and involvement with quality improvement; and hospitalist group age, volume, work shift description, remuneration, and utilization of nurse practitioners, physician assistants, and case managers. Descriptive statistics summarized differences between hospitalist groups and association with patient outcomes. • Results: The groups differed in patient volumes (2093-6022), continuity (maximum 5 vs. 10 consecutive days worked), physician-extender roles, and availability of in-house hospitalist overnight. • Conclusions: Differences exist among hospitalist groups. Organizational characteristics may influence capacity, outcomes, and quality of care delivered on the inpatient services. Further study is needed to determine which organizational feature is associated with improved patient care.