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Hospitalists extend their reach in U.S. hospitals
Plus, new warnings about atypical antipsychotics and pediatric MRSA

Keywords: American Hospital Association shows 20% increase in hospitalists, plus recent effects on inpatient volume and hospital spending





Published in the February 2009 issue of Today's Hospitalist


Hospitalists extend their reach in nation’s hospitals

NEW SURVEY DATA indicate that hospitalists are now a presence in more than half of all U.S. hospitals and that their ranks have swelled to more than 23,000 physicians nationwide.

According to recently released survey data from the American Hospital Association (AHA), the number of hospitalists jumped 20%—from 19,000 to 23,000—between 2006 and 2007. The survey was conducted in February 2007 and was sent to about 5,000 community hospitals. Hospitalist programs had been established in 83% of hospitals that had more than 200 beds. In 2007, the average number of physicians in a hospitalist program was 9.4, compared to 8.3 in 2006.

According to a Society of Hospital Medicine projection based on the AHA data, the number of hospitalists this year should be around 28,000, with hospital medicine programs projected to be in place in 58% of American hospitals.


Warnings about the cardiac effects of atypical antipsychotics

PATIENTS TAKING ATYPICAL ANTIPSYCHOTICS face an increased risk of sudden cardiac death and ventricular arrhythmias, according to new research. An accompanying editorial urged physicians to sharply reduce the use of atypical antipsychotics in vulnerable populations, including children and elderly patients with dementia.

The findings suggest that users taking atypicals face the same risks of sudden cardiac death as those taking typical antipsychotics. Less is known about the newer atypicals, which have been presumed to be safer and have “largely replaced” those older agents, researchers said.

When researchers conducted a retrospective study of Medicaid enrollees in Tennessee, they found that patients’ risk increased with higher doses. The study appeared in the Jan. 15, 2009, New England Journal of Medicine. An accompanying editorial pointed out that among patients taking higher doses, subjects’ rate of sudden cardiac death was 3.3 per 1,000, a level of risk between “moderate” and “low.”

Three atypicals—olanzapine, risperidone and quetiapine—are among the 10 top-selling drugs internationally, according to the editorial.


MRSA behind one out of four pediatric head, neck infections

A NEW STUDY of children’s head and neck infections has found “an alarming nationwide increase” in MRSA in children’s head and neck infections. Researchers tracked more than 20,000 infections caused by staph between 2001 and 2006. Over the course of that period, the percentage of head and neck infections due to MRSA rose from just under 12% to 28%. Nearly half of MRSA samples identified were likewise resistant to clindamycin.

The study is the first national look at the prevalence of MRSA in deeper head and neck tissue infections. Those include sinus and ear infections, as well as abscesses in the throat and tonsils.

The research, which was published in the January 2009 issue of Archives of Otolaryngology—Head & Neck Surgery, also found that close to two-thirds of those infections were community-acquired.


Hospitals react to tighter credit, lower patient volume

RECENT DATA from the American Hospital Association offer a new glimpse of the effects that the economic crisis is having both on inpatient volume and hospital spending. Here are some data from a survey published late last year:


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