Hospitalist staffing requirements.
BACKGROUND
The use of hospitalists--physicians who spend a substantial portion of their time providing in-hospital care to the patients of primary care physicians--has been proposed as a way to decrease costs and increase the quality of inpatient care.


METHODS
Number of full-time hospitalists.


METHODS
Average daily census = annual admissions x length of stay divided by 365. Number of hospitalists = (average daily census divided by patients per hospitalist) + 1 extra hospitalist for night coverage.


METHODS
The average number of patients per hospitalist was obtained from a National Association of Inpatient Physicians membership survey. A low estimate of 10 patients per hospitalist was used to account for the extra manpower needed for coverage during vacations and other time off.


RESULTS
A hospital with 3000 admissions per year and an average length of stay of 5 days would have an average daily census of 41 patients and would need 5 full-time hospitalists. Hospitals with a lower patient volume would need fewer hospitalists and would probably need to find persons other than hospitalists to cover some nights and weekends.


CONCLUSIONS
Simple calculations based on hospital admissions and length of stay can estimate the number of hospitalists required for adequate staffing. Requirements will vary with the hospitalists' workload; the patient case complexity; and the duties other than inpatient care that are required of hospitalists, such as consultations, skilled nursing facility coverage, quality improvement work, teaching, and research.
Lurie
J D
JD
VA Outcomes Group, White River Junction, Vt., USA.
Wachter
R M
RM
D006302:Health Services Research; D020445:Hospitalists / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data; D015233:Models, Statistical; D020380:Needs Assessment / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D014481:United States; D016526:Workload