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The Patient’s Perspective: Is the Hospitalist Model a Viable Option for Obstetrical Care?
Archana Pradhan,= MD, MPH,1 Archana Raman,1 Chung Lim,1  Elizabeth Yoon,1 Cande V. Ananth, PhD, MPH2
1 Division of Obst= etrics and Gynecology, and 2Division of Epidemiology and Biostatistics
 Department of Obstetrics, Gynecology, and Reproductive Sciences
UMDNJ-Robert Wood Johnson Medical School, New Brunswick, N= ew Jersey
=
BACKGRO= UND 
lThe emergence of the hospitalist model has = brought = many changes to the practice of medicine. However,= there is little data on patient perceptions of the model
A better understanding of patient preferences will = show whe= ther the the hospitalist model is effectively addressing patient needs
=
METHODS=
lIRB approval received from UMDNJ-RWJMS to <= /b>conduct a telephone questionnaire to 1,039 patients who delivered at Rob= ert Wood Johnson UMG OB/GYN from January 2002 to December 2004 = ;
lTelephone calls made to patients on weekday= s from 9 A= M to 8 PM and weekends from 9 AM to
3 PM
lThe purpose of the study was explained to t= he patient = and upon gaining verbal consent, the phone survey was administered
Three attempts m= ade to reach each patient
=
RESULTS
The cumulative response rate was 60% resulting in a total of 381 respondents
l<= b>Approximately 86% of respondents indicated their intent to return to their prior OB practice for prenatal care or delivery of their next baby
l<= b>Ninety percent noted their intent to return if they knew their babies would be delivered by specific doctors
l<= b>In contrast, only 32% respondents provided an intent to deliver their n= ext child with the same practice if they knew that a hospitalist was going <= b>to deliver their baby
l<= b>There were a significant number of patients with changes in health insuran= ce, financial status, and prior complications in pregnancy=
=
=
CONCLUS= IONS
lPregnant patients expressed that they would not be content with the hospitalist model =
lPrevious studies on the hospitalist model have = largely overlook= ed the issue of patient satisfaction
lEven though this patient population experienced changes in health insurance, financial status, and complications in pregnancy, these patients wanted to return to a practice where antepartum an= d intrapartum care= was provided by the same physicians
lThis window into how pregnant patients view the model may enable obstetricians to better understand the vital role they play in their patients’ care and satisfaction
=
OBJECTIVE
lTo assess = whether obstetrical patients are likely to = seek care in a practice that delivers prenatal care, = but not intrapartum care
=
REFERENCES
1. Croasdale M. Hospitalists: The next generation. American Medical News 2005; 48(20): 13-14
2. Williams, MV. The future of hospital medicine: Evolution or revolution. American Journal of Medicine 2004; 117: 446-450
3. Rifkin WD, Holmboe E, Scherer H, Sierra = H. Comparison of hospitalists and Nonhospitalists in inpatient length of stay adjusting for patient and physician characteristics. Journal of General Internal Medicine 2004; 19:1127-1132
4. Weinstein L.  The Laborist: A new focus of prac= tice for the obstetrician. American Journal of Obstetrics and Gynecology 2003; 188:310-312
5. Lo B. Ethical and policy implications of hospitalist systems. American Journal of Medicine 2001; 111:52S=
Factors which may affect a patient's choice in returning= to a practice
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