Multispecialty hubs that integrate office-based primary and specialty care with traditional emergency department functions have improved clinical care, increased access and lowered costs compared with the traditional model of medical offices and community hospital EDs, according to the Kaiser Permanente executives pioneering the hub model.
Kaiser Permanente, Mid-Atlantic States (KPMAS) pioneered the multispecialty hub model beginning in 2012 with five full-service medical buildings, each of which serves about 100,000 patients in Virginia, Maryland and the District of Columbia, according to an article in NEJM Catalyst.
The assumption was that about nine out of 10 patients who normally would have been treated at hospital EDs could receive appropriate treatment at a hub able to provide advanced medical, diagnostic, imaging and surgical services across multiple specialties, according to the article. Mental and behavioral health services also are available. Patients can stay in the hub up to 23 hours if necessary before being discharged.
Since the hubs are smaller than hospitals, construction costs are one-fifth those of hospital construction, the officials said in the article. They are located next to large, multispecialty medical offices. If hub patients must be hospitalized, they bypass an ED and are admitted directly to one of Kaiser Permanente’s partner hospitals.
Both hospital days and ED visits per 1,000 members fell 23 percent between 2009 and 2014--check out the article for more stats. The organization plans to build two more multispecialty hubs.
- read the NEJM Catalyst article