Adoption of a gastroenterology hospitalist model and the impact on inpatient endoscopic practice volume: a controlled interrupted time-series analysis

TL;DR

A gastroenterology hospitalist model increased inpatient and outpatient endoscopic procedure volumes in a large academic hospital system.

Contribution

This study provides real-world evidence of the impact of a GE hospitalist model on endoscopic practice volumes.

Findings

Inpatient endoscopic volume increased by 10.9 procedures per week after adopting the hospitalist model.

Outpatient endoscopic volume increased by 39.8 procedures per week, with no change in the number of physicians.

The increase in inpatient volume was statistically significant compared to a traditionally staffed hospital.

Abstract

The gastroenterology (GE) hospitalist staffing model has multiple potential benefits for the inpatient and outpatient care of GE patients. The GE hospitalist model may improve inpatient endoscopy efficiency via better provider familiarity with management of GE emergencies, hospital systems, and workflow, and may also increase outpatient endoscopy capacity by decreasing the need for inpatient coverage by outpatient providers. However, the real-world impact of this model on inpatient and outpatient endoscopic volume remains uncertain.

We conducted a controlled interrupted time-series analysis from September 2018 to March 2020 comparing inpatient endoscopy volume at 2 high-acuity hospitals within the same academic health system, one of which adopted a 2-physician GE hospitalist model in July 2019. We also performed a single interrupted time-series analysis of outpatient endoscopic volume of the practice employing GE hospitalists.

After implementation of the GE hospitalist model, weekly volume of inpatient endoscopic procedures increased by 10.9 (95% CI, .6-21.2; P = .024) compared with a hospital using traditional staffing. Outpatient endoscopic procedure volume also increased by 39.8 per week (95% CI, −5.78 to 85.44; P = .09), with no change in the number of physicians performing endoscopy.

Our findings demonstrate that introduction of a GE hospitalist model increased inpatient and outpatient endoscopic volume in a large academic center.

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