Home From The Editor Hospital medicine’s evolution into post-acute care

Hospital medicine’s evolution into post-acute care

February 2010

Published in the February 2010 issue of Today’s Hospitalist

Has the time come for hospitalists to expand their practice outside of the hospital?

If that seems like a ridiculous question, take a look at one of this month’s features, which looks at health plans that are sending hospitalists out into post-acute settings to provide care to their frequent fliers. These insurers are enlisting the expertise of hospitalists to keep their sickest patients from bouncing back to the hospital for a readmission.

This model of health plans employing hospitalists probably won’t be sweeping the nation anytime soon. But the notion of having hospitalists follow up with patients once they’ve left the hospital may gain traction.

The number of patients at high risk for being readmitted is small, but those patients consume a huge percentage of the nation’s health care resources. Instead of letting patients fall off the edge of the earth once they’ve been discharged, why not have hospitalists stay involved in the post-acute care of those problems that sent these patients to the hospital in the first place?

Health plans that have hospitalists providing such care say the experiment appears to be working, and that readmission rates are down. And with so much attention being paid to unnecessary readmissions, hospitals and even private hospitalist groups will surely be interested in at least exploring the concept.

Many hospitalist groups already follow some patients to skilled nursing facilities and nursing homes. Would hospitalists be interested in following patients into urgent-care centers? The specialty has worked hard to explain why hospitalists are uniquely positioned to provide acute care, so would a major expansion into post-acute care be seen as clashing with that original mission?

I’d like to hear what you have to think. Send a note on this or any other topic (my e-mail address is below), and we’ll consider it for our Letters to the Editor section.

edoyleEdward Doyle
Editor & Publisher