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Pediatric Hospitalists: Quality Care for the Underserved?

Valley Children's Hospital, Madera, Calif, Rwells{at}valleychildrens.org

Barbara Dahl, MA

Valley Children's Hospital, Madera, Calif

Stephen D. Wilson, MD, PhD

Valley Children's Hospital, Madera, Calif

Despite the rapid growth in pediatric hospitalist services, there is little empiric information about the impact of pediatric hospitalists. This study compared process and outcome variables related to the inpatient care of 182 pediatric patients, half of whom were cared for by hospitalists and half by their primary care providers (PCP). Results indicated that, while hospitalists cared for patients of substantially lower socioeconomic status, they delivered care more economically for patients with asthma, with no significant differences in rates of return to the emergency room or rehospitalizations. Children in both services demonstrated equivalent levels of returning to their PCP for follow-up visits and were in equally good health 1 month after discharge. Additionally, no negative impact was evident on patient satisfaction at discharge; in fact, the hospitalists' patients were more satisfied with aspects of their care. Hospitalists may, therefore, provide a vital service by ensuring quality inpatient care for low-income children.

Key Words: Asthma • continuity of care • cost of care • hospitalists • patient satisfaction • pediatrics • quality of care

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