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August 10, 2009

Do Hospitalists Improve Quality?

Arch Intern Med. 2009;169(15):1351-1352. doi:10.1001/archinternmed.2009.245

In this issue, in an article examining the association between hospitalists and performance on hospital-level quality indicators, López 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.