We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Hospitalist Efforts and Improving Discharge Planning—Reply

Vincent Mor, PhD; Richard W. Besdine, MD
JAMA. 2011;305(17):1766-1767. doi:10.1001/jama.2011.563.
Text Size: A A A
Published online


In Reply: We agree with Drs Flansbaum and Williams that the hospitalist movement could make a substantial difference in the care of hospitalized older frail patients. With limited space, we chose not to focus on hospitalists but did reference a recent systematic review that found positive benefits from hospitalists within the hospital and no adverse effects on patients' postdischarge status.1 However, all the studies reviewed were from 1 hospital or a small number of hospitals. A recent study found that 47.1% of hospitals had at least 3 hospitalists in 2006: 83.7% of teaching hospitals and 38.4% of nonteaching hospitals.2 Thus, many hospitalist programs are not part of academic hospitals. Because hospitals are not financially accountable for their patients after discharge, only those hospitals with strong commitments to quality are likely to institute programs designed to ensure continuity of care between hospitalists and patients' primary care physicians. Evidence suggests that hospitalist programs can be effective, but internal changes for efficiency do not assure better outcomes after discharge. We need empirical evidence regarding performance of a representative sample of hospitalist programs, regardless of the sponsorship under which they operate. Assuming that all programs are as effective as the literature may miss important opportunities for improving patients' experiences and outcomes.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




May 4, 2011
Bradley Flansbaum, DO, MPH, SFHM; Mark V. Williams, MD, FHM
JAMA. 2011;305(17):1766-1767. doi:10.1001/jama.2011.562.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.