Abstract 739

Current Health Care Economics has forced a division between inpatient and outpatient care. As a result, Hospitalist Services are becoming more common. Our group provides a 24 hour a day, 7 day a week Hospitalist Service which provides dedicated delivery room (DR) coverage and in hospital care for all babies born in two community hospitals. Since its initiation, the service has cared for almost 10,000 infants. The cost of this service is paid for by professional fees. We surveyed the 44 Obstetricians, 56 Pediatricians and 151 Birth Center Nurses we serve about how DR and nursery coverage should be provided, how the service has effected their practices and quality of life, and the quality of care and satisfaction of their patients. 50% of Obstetricians, 68% of Pediatricians and 34% of Nurses responded. Responses were measured on a scale of 1 to 5 (1=strongly disagree, 3= neutral, 5=strongly agree). The Obstetricians, Pediatricians and Nurses all felt strongly (3.9,3.8,4.6, respective mean scores) that DR and nursery care should be provided by a Hospitalist Service. None of the groups felt the Pediatrician needed to provide care for their patients starting with the delivery (2.7,2.6,2.4). All groups felt the care provided by the service was excellent (4.4, 4.7, 4.4), that emergencies were handled more quickly and smoothly compared to the previous coverage system (4.1, 4.7, 4.6), that their relationships with their patients were unchanged (4.6, 4.1, 4.2) and that their patients were happy with the care they received (4.3, 4.3, 4.5). The Pediatricians did not enjoy performing resuscitations (2.5) and did not miss being in the DR (2.5), but were somewhat concerned they would lose their resuscitation skills (3.5). They also felt the service was an acceptable substitute for their own care of patients in the hospital (4.2) and that they received enough information from the service to provide appropriate follow-up care (4.2). They felt the service had benefited their practices (4.5) and improved the quality of their lives (4.9), but were neutral with respect to the effect the service had on their incomes (3.1). The Obstetricians and Nurses also felt the service had benefited their practices (4.2, 4.6).

The institution of a newborn Hospitalist Service in two community hospitals has been well received by patients and medical staff and increased the quality of the lives of the physicians it serves.