title: Characteristics of primary care providers who adopted the hospitalist model from 2001 to 2009.
abstract: BACKGROUND
  The characteristics of primary care providers (PCPs) who use hospitalists are unknown.
  
  
  METHODS
  Retrospective study using 100% Texas Medicare claims from 2001 through 2009. Descriptive statistics characterized proportion of PCPs using hospitalists over time. Trajectory analysis and multilevel models of 1172 PCPs with ≥20 inpatients in every study year characterized how PCPs adopted the hospitalist model and PCP factors associated with this transition.
  
  
  RESULTS
  Hospitalist use increased between 2001 and 2009. PCPs who adopted the hospitalist model transitioned rapidly. In multilevel models, hospitalist use was associated with US training (odds ratio [OR] 1.46, 95% confidence interval [CI]: 1.23-1.73 in 2007-2009), family medicine specialty (OR: 1.46, 95% CI: 1.25-1.70 in 2007-2009), and having high outpatient volumes (OR: 1.32, 95% CI: 1.20-1.44 in 2007-2009). Over time, relative hospitalist use decreased among female PCPs (OR: 1.91, 95% CI: 1.46-2.50 in 2001-2003; OR: 1.50, 95% CI: 1.15-1.95 in 2007-2009), those in urban locations (OR: 3.34, 95% CI: 2.72-4.09 in 2001-2003; OR: 2.22, 95% CI: 1.82-2.71 in 2007-2009), and those with higher inpatient volumes (OR: 1.05, 95% CI: 0.95-1.18 in 2001-2003; OR: 0.55, 95% CI: 0.51-0.60 in 2007-2009). Longest-practicing PCPs were more likely to transition in the early 2000s, but this effect disappeared by the end of the study period (OR: 1.35, 95% CI: 1.06-1.72 in 2001-2003; OR: 0.92, 95% CI: 0.73-1.17 in 2007-2009). PCPs with practice panels dominated by patients who were white, male, or had comorbidities are more likely to use hospitalists.
  
  
  CONCLUSIONS
  PCP characteristics are associated with hospitalist use. The association between PCP characteristics and hospitalist use has evolved over time.
authors: Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Romsai T
authors: RT
authors: Boonyasai
authors: Yu-Li
authors: YL
authors: Lin
authors: Daniel J
authors: DJ
authors: Brotman
authors: Yong-Fang
authors: YF
authors: Kuo
authors: James S
authors: JS
authors: Goodwin
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D020445:Hospitalists / Q000639:trends*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D006278:Medicare / Q000639:trends*; D058007:Physicians, Primary Care / Q000639:trends*; D012017:Referral and Consultation / Q000639:trends*; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
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