{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:31:41Z","timestamp":1784633501020,"version":"3.55.0"},"reference-count":19,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>The goal of this study was to assess outcomes and costs associated with hospitalist comanagement of medically complex children undergoing spinal fusion surgery for neuromuscular scoliosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>A hospitalist comanagement program was implemented at a children\u2019s hospital. We conducted a retrospective case series study of patients during 2003\u20132008 to compare clinical and cost outcomes for 87 preimplementation patients, 40 patients during a partially implemented program, and 80 patients during a fully implemented program.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>When compared with preimplementation patients, full implementation program patients did not demonstrate a statistically significant difference in median length of stay on the medical\/surgical unit after transfer from the PICU (median: 6 vs 8 days; P = .07). Patients in the full implementation group received fewer days of parenteral nutrition (median: 0 vs 6 days; P = .0006) and had fewer planned and unplanned laboratory studies on the inpatient unit. There was no statistically significant change in returns to the operating room (P = .08 between preimplementation and full implementation), other complications, or 30-day readmissions. Median hospital costs increased from preimplementation ($59 372) to partial implementation ($89 302) and remained elevated during full implementation ($81 651) compared with preimplementation (P = .004). Mean physician costs followed a similar trajectory from preimplementation ($18 425) to partial implementation ($24 101) to full implementation ($22 578; P = .0006 [versus preimplementation]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>A hospitalist comanagement program can significantly affect the care of medically complex children undergoing spinal fusion surgery. Initial program costs may increase.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2012-0066","type":"journal-article","created":{"date-parts":[[2013,9,27]],"date-time":"2013-09-27T17:52:00Z","timestamp":1380304320000},"page":"233-241","source":"Crossref","is-referenced-by-count":50,"title":["Outcomes and Costs Associated With Hospitalist Comanagement of Medically Complex Children Undergoing Spinal Fusion Surgery"],"prefix":"10.1542","volume":"3","author":[{"given":"David I.","family":"Rappaport","sequence":"first","affiliation":[{"name":"Department of General Pediatrics"},{"name":"Department of Pediatrics, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Adelizzi-Delany","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth J.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chalanda E.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Petrini","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Chaplinski","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ostasewski","sequence":"additional","affiliation":[{"name":"Department of Operational Finance, Nemours\/Alfred I. duPont Hospital for Children, Wilmington, Delaware; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iman","family":"Sharif","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Pressel","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2013,7,1]]},"reference":[{"issue":"4","key":"2021120908231364800_B1","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1016\/j.pcl.2005.03.007","article-title":"Hospitalist care of the medically complex child","volume":"52","author":"Srivastava","year":"2005","journal-title":"Pediatr Clin North Am"},{"issue":"4","key":"2021120908231364800_B2","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1542\/peds.2009-1658","article-title":"Increasing prevalence of medically complex children in US hospitals","volume":"126","author":"Burns","year":"2010","journal-title":"Pediatrics"},{"issue":"4","key":"2021120908231364800_B3","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1542\/peds.2009-3266","article-title":"Children with complex chronic conditions in inpatient hospital settings in the United States","volume":"126","author":"Simon","year":"2010","journal-title":"Pediatrics"},{"issue":"3","key":"2021120908231364800_B4","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1542\/peds.2010-0910","article-title":"Children with medical complexity: an emerging population for clinical and research initiatives","volume":"127","author":"Cohen","year":"2011","journal-title":"Pediatrics"},{"key":"2021120908231364800_B5","article-title":"Surgical care for medically complex children: a multidisciplinary program","author":"Rappaport"},{"issue":"4","key":"2021120908231364800_B6","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1001\/archinternmed.2009.553","article-title":"Comanagement of hospitalized surgical patients by medicine physicians in the United States","volume":"170","author":"Sharma","year":"2010","journal-title":"Arch Intern Med"},{"issue":"4 pt 2","key":"2021120908231364800_B7","doi-asserted-by":"crossref","first-page":"343","DOI":"10.7326\/0003-4819-130-4-199902161-00003","article-title":"Hospitalists and the practice of inpatient medicine: results of a survey of the National Association of Inpatient Physicians","volume":"130","author":"Lindenauer","year":"1999","journal-title":"Ann Intern Med"},{"key":"2021120908231364800_B8","unstructured":"Society of Hospital Medicine. 2005-2006 SHM Survey: state of the hospital medicine movement. Available at: http:\/\/dev.hospitalmedicine.org\/AM\/Template.cfm?Section=Survey&Template=\/CM\/ContentDisplay.cfm&ContentID=14352. Accessed April 17, 2012."},{"issue":"5","key":"2021120908231364800_B9","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1002\/jhm.361","article-title":"Just because you can, doesn\u2019t mean that you should: a call for the rational application of hospitalist comanagement","volume":"3","author":"Siegal","year":"2008","journal-title":"J Hosp Med"},{"issue":"2","key":"2021120908231364800_B10","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/BF02596302","article-title":"Preoperative medical consultations in a community hospital","volume":"2","author":"Ferguson","year":"1987","journal-title":"J Gen Intern Med"},{"issue":"1","key":"2021120908231364800_B11","doi-asserted-by":"crossref","first-page":"28","DOI":"10.7326\/0003-4819-141-1-200407060-00012","article-title":"Medical and surgical comanagement after elective hip and knee arthroplasty: a randomized, controlled trial","volume":"141","author":"Huddleston","year":"2004","journal-title":"Ann Intern Med"},{"issue":"3","key":"2021120908231364800_B12","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/01.bot.0000202220.88855.16","article-title":"Outcomes for older patients with hip fractures: the impact of orthopedic and geriatric medicine cocare","volume":"20","author":"Fisher","year":"2006","journal-title":"J Orthop Trauma"},{"issue":"7","key":"2021120908231364800_B13","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1001\/archinte.165.7.796","article-title":"Effects of a hospitalist model on elderly patients with hip fracture","volume":"165","author":"Phy","year":"2005","journal-title":"Arch Intern Med"},{"issue":"22","key":"2021120908231364800_B14","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1001\/archinternmed.2010.432","article-title":"Comanagement of surgical patients between neurosurgeons and hospitalists","volume":"170","author":"Auerbach","year":"2010","journal-title":"Arch Intern Med"},{"issue":"1","key":"2021120908231364800_B15","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/jhm.144","article-title":"Pediatric hospitalist comanagement of spinal fusion surgery patients","volume":"2","author":"Simon","year":"2007","journal-title":"J Hosp Med"},{"issue":"1","key":"2021120908231364800_B16","first-page":"14","article-title":"Nurses\u2019 assessment of pediatric physicians: are hospitalists different?","volume":"53","author":"Pressel","year":"2008","journal-title":"J Healthc Manag"},{"issue":"2","key":"2021120908231364800_B17","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1177\/0009922807306789","article-title":"Pediatric hospitalist comanagement of surgical patients: challenges and opportunities","volume":"47","author":"Rappaport","year":"2008","journal-title":"Clin Pediatr (Phila)"},{"key":"2021120908231364800_B18","unstructured":"US Department of Labor, Bureau of Labor Statistics. Databases, tables & calculators by subject. Available at: www.bls.gov\/data\/inflation_calculator.htm. Accessed October 16, 2012."},{"issue":"11","key":"2021120908231364800_B19","doi-asserted-by":"crossref","first-page":"866","DOI":"10.7326\/0003-4819-137-11-200212030-00007","article-title":"Effects of physician experience on costs and outcomes on an academic general medicine service: results of a trial of hospitalists","volume":"137","author":"Meltzer","year":"2002","journal-title":"Ann Intern Med"}],"container-title":["Hospital Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/3\/3\/233\/839257\/hpeds_2012-0066.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/3\/3\/233\/839257\/hpeds_2012-0066.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T02:42:40Z","timestamp":1639104160000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article\/3\/3\/233\/73373\/Outcomes-and-Costs-Associated-With-Hospitalist"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,1]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2013,7,1]]},"published-print":{"date-parts":[[2013,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/hpeds.2012-0066","relation":{},"ISSN":["2154-1663","2154-1671"],"issn-type":[{"value":"2154-1663","type":"print"},{"value":"2154-1671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,1]]}}}