The use of hospitalists has spread to smaller rural hospitals, but no studies in the peer-reviewed literature have examined their use in these settings. This project will begin to fill the gaps in existing knowledge by examining why and how hospitalists are being used in rural hospitals and the impact of their use on the provision of inpatient and primary care in rural communities.

Project goals: This project has two purposes: 1) to describe trends over time in the use of hospitalists by rural hospitals, characteristics of rural hospitals that use hospitalists, and the types of hospitalist models being used and 2) to assess the impact of hospitalist use on the provision of inpatient and primary care in rural areas, with a particular focus on physician supply, the quality of pneumonia care and patient satisfaction.

Methods: This project includes a descriptive analysis of hospitalist use using data from FY 2005- 2009 AHA Annual Surveys and from a national survey of rural hospitals using hospitalists, and multivariate analyses of the relationships between hospitalist use and primary care physician supply, the quality of inpatient care and patient satisfaction in rural hospitals.

Anticipated Publications or Products: Policy briefs, a final report, a peer-reviewed journal manuscript, and abstracts for presentations at regional and/or national conferences.

Publications

• The Use of Hospitalists by Small Rural Hospitals: Results of a National Survey
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 06/2014
  Examines reasons for using hospitalists, characteristics of hospitalist practices, and the impacts of hospitalist use in rural settings.
• The Use of Hospitalists in Small Rural Hospitals
  Upper Midwest Rural Health Research Center
  Date: 04/2012
  This policy brief describes the results of a survey of small rural hospitals that use hospitalists, who are physicians, physician assistants, or nurse practitioners who assume responsibility for patient care during inpatient hospital stays.