Hospitalist

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Oct 8, 2015

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Hospitalist

1. 2. 3. Hospitalist

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1950 1965 1980 1995 2010

CT

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1. Primary care

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(1) ?(2) ?(3) ?(4) /?(5) ?(6) ?(7) ?(8) ?

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- Bed-side teaching- Class teaching

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:NEJM 1996 : Hospitalist

A hospital-based general physicianfrom outpatient to inpatient and vice versainpatient care, teaching, research, administration

Hospital medicine: medical care of acutely ill hospitalized patients

Hospitals home team- Resident/Intern + Intensivists + ED physicians

NEnglJMed2009;360:110212.

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+ HOSPITALIST

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Hospitalist

Care of overflow general medical and medical oncology patients

Care of unassigned patients from EDCare of surgical patients allows the surgeon to be in the operation room all day while ensuring that the floor patient is being well and efficiently managed. (co-management)

General medicine consultation

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Hospitalist program

, , (24h/7d) , , , (co-management)

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(Disease-Centered Medical Model) (Reductionism)

(Person-Centered Bio-Psycho-Social Model) (Holism)

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Hospitalist=Specialists in Inpatient MedicineHospitals home team- Resident/Intern, Intensivists, ED physicians + HOSPITALIST

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Hospitalist-On-Site, 24/7 Coverage

ACGME

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24/7

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Hospitalist

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92 86 72 64 59 54- 51- 36 31 28 25 21 Source: SHM 2006a 27

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Hospital Medicine in Taiwan

Leading hospitalist program in Taiwan: NTUH, since Oct 2009.

Hospitalist program for 2-year young VS obligation for primary care: Chang-Gang Medical Center, since 2006

ED observation units model:Chi Mei Medical Center in Southern Taiwan, since Aug 2012. And so on.

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(hospitalist)

()

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(Hospitalist in NTUH: HINT)

H: Holistic

I: Integrated

N: Non-Border

T: Touch-Service

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Certification Dr. Lin Dr. Tsai Dr. Shu Dr. Hsu Dr. Hua Dr. Cho Dr. Chu Dr. TseACLS

Internal Med.

Nephrology

Pulmonary & Critical Care

Family Med.

Geriatrics

Infection

Palliative & Hospice

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Multidisciplinary combined care

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37.8%62.2%

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1.

4242

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2.

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3. : (Ward OPD)- , 8:00-21:00- ,

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,

(Call Center)- - :1371430180 1- ,

(ex)

(ex)

-- ECOG 2

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Length of Stay > 3 days in ED

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Shu & Lin et al, BMC Med. 2011 Aug 17;9:96.

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[PDTC]: 8AM-8PM Call Center + 2 1,7,14,30

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CAS

CPR

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Hospitalist

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Hospitalist careerJob/

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Hospitalist?

Hospitalist?

Hospitalist?

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Hospitalist System Career Satisfaction

Career Satisfaction Task Force 200657

(Task control)

/(Org. control)

(Physical

environmental control)

(Resource

control)

(Job fit)

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:1040806()150

:1040910()150

:104117 () 80

:1041226()130103

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DRG

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::(1) ?(2) ?(3) ?(4) ?(5) ?(6) ?(7) ?

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: Hospitalist

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Principles and Practice of Hospital Medicine, McGraw-Hill Medical; 1 edition, 2012

Hospital Medicine: Just The Facts, McGraw-Hill Education / Medical; 1 edition, 2008

Hospitalists: A Guide to Building and Sustaining a Successful Program, Health Administration Press; 1 edition, 2007

Society of Hospital Medicine Career Satisfaction Task Force. A challenge for a new specialty: a white paper on hospitalist career satisfaction. Society of Hospital Medicine, 2006.

Society for Hospital Medicine, http://http://www.hospitalmedicine.org

The American Board of Hospital Medicine, http://http://www.abpsus.org/hospitalist

, http://hospitalist.twnct.net

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