Research

The Villages Health Hospitalist Evaluation

In general, when a patient is admitted to the hospital, their 'overall' care is overseen by a hospitalist ~ a doctor who is trained in hospital based medicine. These doctors typically work for the hospital itself and review and provide care for hospital based patients, as well as connecting patients with appropriate specialists where needed. Having hospitalist's can be very beneficial ~ they are very familiar with their hospital setting, they know how to access resources on patients behalf, they usually know the skills and backgrounds of specialists who work within the hospital system, and they are on site across multiple time points.

There can be some challenges with hospitalist programs, however. For example, hospitalists often don't have access to a patients entire medical history or real time access to results from tests that were conducted on an out-patient basis, and in many cases, they may not have familiarity with or time to connect with patients primary care doctors to communicate regarding patients at discharge.

To help overcome some of these challenges, The Villages Health has started an innovative hospitalist program where Villages Health patients have the opportunity to be treated by a Villages Health hospitalist when they are in the hospital. Because they are from within the Villages Health system, they have full access to a patients medical chart and prior health history and they have good communications systems in place to follow up with both patients and primary care doctors within the care system to ensure patients get the after care they need following discharge. This has the potential to improve patient health outcomes, reduce time in hospital, and ensure patients are receiving quick and adequate care once they leave the hospital and return to the community.

This TVH Hospitalist Evaluation tracks hospitalized TVH patients to identify differences in health outcomes for TVH Medicare Advantage patients (treated by a TVH hospitalist) and TVH patients without TVH Medicare Advantage (treated by a non-TVH hospitalist). Using data from electronic medical records and TVH records, analysis compares aspects of patients' hospital treatment (i.e. length of stay, number of consultations), post-discharge health and identify trends in health care utilization before the patient was hospitalized.

Preliminary analysis from 2016 hospitalization data has found that TVH Medicare Advantage patients had lower rates of hospitalization, shorter length of stay, and quicker primary care follow up times than patients with alternative insurance plans.