International experience with a hospital medicine care system and lessons for Taiwan

A hospital medicine care system is a type of integrated care for inpatients provided by a fixed group of attending physicians with a complete handover system. They also work with other team members to take care of hospitalized patients in order to improve system performance. The objectives of this system are to promote the safety of inpatients, improve the quality of care, and utilize medical care resources more appropriately. The United States was the first country to implement this system, and was followed by the United Kingdom, Canada, Singapore, and Japan. Each country developed its care system and specialty training programs according to its own conditions. Taiwan also initiated a trial program in some hospitals in June, 2015. This paper reviews the development and practice experience of major countries with hospital medicine care systems, in hope of inspiring the development of hospital medicine in Taiwan. Based on international experience, the authors suggest strengthening the recruitment, training, and career development of hospital medicine specialists, elevating the degree of support from top management, and increasing the recognition by patients that hospital medicine specialists are key factors in helping Taiwan develop its own hospital medicine care system.