Hospitalist Model Implementation in a Chilean Medical Service: Eight Years of Diagnosis-Related Group Indicators
Journal
REVISTA MEDICA DE CHILE
Date Issued
2025
Author(s)
Carrillo-Bestagno, Hernan
Zepeda, Georgina
Cartes- Velasquez, Ricardo
Rivera, Francisca
Muller-Ortiz, Hans
Conejeros-Rodriguez, Consuelo
Abstract
The implementation of the hospitalist model (HM) in public hospitals across Latin America has been scarcely documented. In Chile, the Diagnosis-Related Groups (DRG) system enables standardized analysis of hospital performance; however, its longitudinal behavior in the context of organizational reform remains underexplored. Aim: To describe historical trends in DRG-based indicators of productivity and morbidity-mortality in the Internal Medicine Service (IMS) of Hospital Las Higueras de Talcahuano (HHT) from 2012 to 2019, during the progressive implementation of the hospitalist model. Methods: A retrospective, observational, and descriptive study was conducted using the full set of hospital discharges from IMS-HHT coded by DRG. Two operationally defined periods were compared: P1 (2012-2016, traditional care model) and P2 (2016-2019, hospitalist model implementation). Four indicator domains were analyzed: general, process, complexity, and outcomes. Due to the population-based nature of the data, no statistical tests for significance were applied. Results: IMS accounted for 13.8% to 17.5% of total HHT discharges. During P2, an increase in the average DRG weight and in the proportion of severe cases was observed. The adjusted length-of-stay index (ALOSi) initially rose and then steadily declined from the third year onward. Urgent readmissions and hospital mortality rates consistently decreased starting from the beginning of P2. Conclusions: The temporal evolution of DRG indicators suggests a pattern of sustained improvement in clinical and administrative performance during the implementation of the hospitalist model, without inferring causal relationships.


