Effects of Establishing a Department of General Internal Medicine on the Length of Hospitalization

Wada, Mikio; Nishiyama, Daichi; Kawashima, Atsushi; Fujiwara, Misaki; Kagawa, Keiichiro

doi:10.2169/internalmedicine.54.3900

Cited by 7 publications

(7 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a previous study, the establishment of a GIM department was associated with a reduction of the length of hospitalization in pneumonia patients ( 5 ). Other studies have also shown that patients cared by hospitalists had a shorter length of hospitalization than those who were cared for by non-hospitalists ( 16 - 18 ).…”

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

The Association between the Establishment of a General Internal Medicine Department and an Increased Number of Blood Cultures in Other Departments: An Interrupted Time Series Analysis

et al. 2021

View full text Add to dashboard Cite

Objective The establishment of a department of general internal medicine (GIM) has been shown to improve the clinical outcomes among patients treated in GIM departments but the effect on practice patterns in other departments remains unclear. We evaluated the association between the establishment of a GIM department and the use of blood cultures, an indicator of quality of care of infectious diseases, in other departments. Methods This study was conducted between 2013 and 2017 in a community hospital which established a new GIM department in 2015, with a mandate to improve the quality of care of the hospital including infectious disease management. The primary outcome was the change in the number of blood culture episodes per calendar month in other departments before and after establishment of the GIM department. The secondary outcome was the change in the blood culture episodes per month, indexed to 1,000 patient-days, during the same time. Using 2015 as the phase-in period, interrupted time series analyses were used to evaluate the change in the outcome variables. Results In departments other than GIM, there were 284 blood cultures prior to the establishment of the GIM department (2013)(2014) and 853 afterwards (2016)(2017). The number of blood culture episodes in other departments increased by 10.7 (95%CI: 0.39-21.0, p=0.042) per calendar month after the establishment of the GIM department; blood culture episodes / calendar month / 1,000 patient-days increased by 0.55 (95% CI: 0.03-1.07 p=0.037). Conclusion These results indicate that a GIM department in a community hospital can improve the quality of care in other departments.

show abstract

Section: Discussionmentioning

confidence: 92%

“…A recent Japanese study showed that establishing a GIM department was associated with a shorter length of hospitalization among pneumonia patients ( 5 ). However, it evaluated only patients cared for by GIM physicians.…”

Section: Introductionmentioning

confidence: 99%

The Association between the Establishment of a General Internal Medicine Department and an Increased Number of Blood Cultures in Other Departments: An Interrupted Time Series Analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In a previous study, the establishment of a department of GIM was associated with a reduction in the length of hospital stay in patients with pneumonia. [ 2 ] Another report showed that it was associated with an increased number of blood cultures ordered in other departments. [ 13 ] Due to the shortage of IDSs, ID and GIM physicians should cooperate to promote the quality of care and clinical management in hospitals in Japan.…”

Section: Discussionmentioning

confidence: 99%

Infectious diseases consultations from general internal medicine physicians in Japan: A descriptive single-center study

et al. 2022

View full text Add to dashboard Cite

In Japan, general internal medicine (GIM) physicians must be aware of frequently encountered infections because of the shortage of infectious disease (ID) specialists. However, there are currently no epidemiological data on this subject. This study aimed to describe the frequency and pattern of ID consultations requested by GIM physicians in Japan. This is a 3-year retrospective review of the ID consultations requested by GIM physicians in Japan at a community-based acute tertiary care teaching hospital in Tokyo from April 2018 to March 2021. Demographic data, such as reasons for consultation, causative organism, and final diagnoses, were collected. During the study period, ID consultations were requested by GIM physicians 128 times. The incidence rates of bacteremia and 30-day mortality were 65.6% (n = 84) and 3.1% (n = 4), respectively. The most common diagnostic classifications after ID consultation were bone/joint (24.2%, n = 31), respiratory (17.7%, n = 22), and cardiovascular infections (12.5%, n = 16). The most common final diagnoses were bacteremia (11.7%, n = 15), infective endocarditis (9.4%, n = 12), and vertebral osteomyelitis (7.8%, n = 10). This is the first study to describe the ID consultation cases requested by GIM physicians in Japan in a community-based acute tertiary care teaching hospital. Despite the shortage of ID specialists, GIM physicians covered a wide range of IDs, including bone/joint infections and infectious endocarditis, which require long-term care. ID and GIM physicians, including hospitalists, should cooperate to promote the quality of care and clinical management. Future multi-center studies with large numbers of clinical cases are needed to determine the ID clinical knowledge required by GIM physicians in Japan.Abbreviations: GIM = general Internal medicine, HIV = human immunodeficiency virus, ID = infectious diseases, IDS = infectious disease specialist.

show abstract

“…Hospitalists prioritise quality and safety of medical care over non-hospitalist generalists. Studies have shown that the presence of hospitalists in Japan has shortened hospital stays and reduced costs for common diseases such as pneumonia and heart failure [24][25][26]. Similarly, a report summarising the role of hospitalists in four Asian countries also emphasizes the importance of their role in addressing healthcare quality [5].…”

Section: Discussionmentioning

confidence: 99%

Roles considered important for hospitalist and non-hospitalist generalist practice in Japan: A survey study

Miyagami

Shimizu

Kosugi

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: An increased focus on quality and patient safety led to the evolution of the hospitalist specialty. The number of hospitalists, who cover ward and outpatient care, is on the rise in Japan. However, it is unclear what roles hospitalists themselves consider important in their practice. Therefore, this study aimed to investigate what hospitalists and non-hospitalist generalists in Japan consider important for the practice of their specialty. Methods:This was an observational study that included Japanese hospitalists (1) currently working in a general medicine (GM) or general internal medicine department and (2) working at a hospital. Using originally developed questionnaire items, we surveyed what they think are important to hospitalists and what are important compared to that for non-hospitalist generalists. Results: There were 971 participants (733 hospitalist, 238 non-hospitalist) in the study. The response rate was 26.1％. Both hospitalists and non-hospitalists ranked evidence-based medicine as most important for their practice. Hospitalists ranked diagnosis and patient management as the second and third most important roles for their practice while non-hospitalists ranked patient management and elderly care as second and third. Conclusions: This is the first study investigating what roles Japanese hospitalists consider important and compare those to that of non-hospitalist generalists. Many of the items that hospitalists responded to that they actually consider important were those that hospitalists in Japan are actually working on within and outside of academic societies. We found that diagnostic medicine, and quality and safety are likely to be evolved by hospitalists because they specifically emphasized them, while the care of the elderly is an issue that hospitalists should be more concerned about. Future expected research includes proposals on how to further enhance items that hospitalists emphasize and should focus on, as well as international comparisons regarding the items.

show abstract

Effects of Establishing a Department of General Internal Medicine on the Length of Hospitalization

Cited by 7 publications

References 17 publications

The Association between the Establishment of a General Internal Medicine Department and an Increased Number of Blood Cultures in Other Departments: An Interrupted Time Series Analysis

The Association between the Establishment of a General Internal Medicine Department and an Increased Number of Blood Cultures in Other Departments: An Interrupted Time Series Analysis

Infectious diseases consultations from general internal medicine physicians in Japan: A descriptive single-center study

Roles considered important for hospitalist and non-hospitalist generalist practice in Japan: A survey study

Contact Info

Product

Resources

About