Yonsei Med J.  2023 Sep;64(9):558-565. 10.3349/ymj.2023.0143.

Effect of Active Surgical Co-Management by Medical Hospitalists in Urology Inpatient Care: A Retrospective Cohort Study

• Kim ES
• Ohn JH
• Lim Y
• Lee J
• Kim HW
• Kim Sw
• Ryu J
• Park HS
• Cho JH
• Oh JJ
• Byun SS
• Jang HC
• Kim NH

• KMID: 2545519
• DOI: http://doi.org/10.3349/ymj.2023.0143

Abstract

Purpose
This study aimed to evaluate the use of active surgical co-management (SCM) by medical hospitalists for urology inpatient care.
Materials and Methods
Since March 2019, a hospitalist-SCM program was implemented at a tertiary-care medical center, and a retrospective cohort study was conducted among co-managed urology inpatients. We assessed the clinical outcomes of urology inpatients who received SCM and compared passive SCM (co-management of patients by hospitalists only on request; March 2019 to June 2020) with active SCM (co-management of patients based on active screening by hospitalists; July 2020 to October 2021). We also evaluated the perceptions of patients who received SCM toward inpatient care quality, safety, and subjective satisfaction with inpatient care at discharge or when transferred to other wards.
Results
We assessed 525 patients. Compared with the passive SCM group (n=205), patients in the active SCM group (n=320) required co-management for a significantly shorter duration (p=0.012) and tended to have a shorter length of stay at the urology ward (p=0.062) and less frequent unplanned readmissions within 30 days of discharge (p=0.095) while triggering significantly fewer events of rapid response team activation (p=0.002). No differences were found in the proportion of patients transferred to the intensive care unit, in-hospital mortality rates, or inpatient care questionnaire scores.
Conclusion
Active surveillance and co-management of urology inpatients by medical hospitalists can improve the quality and efficacy of inpatient care without compromising subjective inpatient satisfaction.

Keyword

Hospitalist; urology; inpatients; patient care; surgical co-management