Do hospitalists improve quality?

摘要

IN THIS ISSUE, IN AN ARTICLE EXAMINING THE AS-sociation between hospitalists and performance on hospital-level quality indicators, Lopez and colleagues1 found that hospitals with hospitalists have higher "quality of care" scores than those without hospitalists and attribute these improvements to the hospitalists' presence. This article provides interesting data, which unfortunately are not persuasive enough to support that conclusion. This editorial addresses several important issues: the definition of quality, the value of performance measures, the difference between quality and safety, alternative analyses, alternative explanations, and finally, what questions should we ask in 2009 about hospitalists and quality.