TY - JOUR
T1 - Characteristics of primary care providers who adopted the hospitalist model from 2001 to 2009
AU - Boonyasai, Romsai T.
AU - Lin, Yu Li
AU - Brotman, Daniel J.
AU - Kuo, Yong Fang
AU - Goodwin, James S.
N1 - Publisher Copyright:
© 2015 Society of Hospital Medicine.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - BACKGROUND: The characteristics of primary care providers (PCPs) who use hospitalists are unknown.METHODS: 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.RESULTS: 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.CONCLUSIONS: PCP characteristics are associated with hospitalist use. The association between PCP characteristics and hospitalist use has evolved over time.
AB - BACKGROUND: The characteristics of primary care providers (PCPs) who use hospitalists are unknown.METHODS: 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.RESULTS: 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.CONCLUSIONS: PCP characteristics are associated with hospitalist use. The association between PCP characteristics and hospitalist use has evolved over time.
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U2 - 10.1002/jhm.2269
DO - 10.1002/jhm.2269
M3 - Article
C2 - 25627347
AN - SCOPUS:85006312559
SN - 1553-5606
VL - 10
SP - 75
EP - 82
JO - Journal of Hospital Medicine
JF - Journal of Hospital Medicine
IS - 2
ER -