The hospitalist movement and the benefits for Australian Psychiatry Services

To the Editor

Pai and Vella (2021) address a core debate in psychiatric service configuration about whether inpatient and outpatient treatment should be provided by the same or different psychiatrists. They concluded that ‘continuity of care’ supersedes the current ‘functionally split system’ in Australia, based on better patient care outcomes. We, however, found that of all the sources referenced by authors, there was only one study that directly compared the two systems of care, finding that either option had no substantial impact on patient outcomes over a 1-year period including re-hospitalisation rates, number of inpatient days, adverse events and patients’ social situation (Giacco et al., 2018). Both the Australian public sector and UK National Health Service psychiatric services have largely shifted to the ‘functionally split model’ of having different psychiatrists in inpatient and outpatient care, suggesting that healthcare systems in these countries accrue significant benefits with this form of site-level specialisation.

In this context, it is important to specifically consider the evidence obtained from the US ‘hospitalist movement’...