HM Improves Quality in Singapore


The HM model has solidified its global status.

A group of family physicians in Singapore studied the implementation of a hospitalist program at Singapore General Hospital, according to a Journal of Hospital Medicine report. The researchers found that, compared with patients under the care of specialists, those cared for by hospitalists had shorter lengths of stay (adjusted LOS, geometric mean, GM 4.4 vs. 5.3 days; P<0.001) and reduced costs (adjusted cost, GM, $2,250.70 vs. $2,500; P=0.003). The researchers also found a similar inpatient mortality rate (4.2% vs. 5.3%, P=0.307) and 30-day all-cause unscheduled readmission rate (7.5% vs. 8.4%, P=0.231).

"These findings suggest that the hospitalist care model can be adapted for health systems outside North America and may produce similar beneficial effects in care efficiency and cost savings," the authors concluded.

The initiative in Singapore, a city-state in Southeast Asia with a population close to 5 million, is not the first adoption of the HM model outside the U.S. But the data showing reduced LOS and costs is further evidence of both the growth and the efficacy of the HM movement worldwide, says Kheng Hock Lee, MBBS, MMed, FCFP, one of the study authors.

"Our study showed very similar improvement in care outcomes with hospitalist programs in the United States, although we are thousands of miles apart and with a different culture and healthcare system," Kheng Hock wrote in an e-mail to The Hospitalist eWire. "I think the success of the hospitalist care model stems from the recognition that it fulfills an emergent need that has resulted from the increase in complexity of healthcare and the need for specialization in medicine.

"The need for a good generalist in the hospital setting who can coordinate care and treat patient holistically is intuitively recognized by policymakers, healthcare providers, and patients."

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