Background: Hospital Medicine has grown rapidly as a clinical specialty, but the specialty’s inroads in research have been more limited. We sought to understand the current state of research in adult Hospital Medicine.
Methods: We repeated a 2018 survey of leaders in the field with changes to improve the response rate and representativeness of surveyed programs. We summarized survey results using descriptive statistics. Separately, we analyzed public sources of data regarding research funding and publications from 2010 through 2019 among members of the Society of Hospital Medicine (SHM). In our analyses of public data, we calculated mean federal research funding and MEDLINE-indexed publications per SHM member per year. We used linear regression to assess for trends over time in each outcome.
Results: Of 102 contacted leaders of hospital medicine groups across the country, 42 (41%) completed the survey and 7 submitted partial responses, for a total response rate of 48%. Among the 3,397 faculty members represented in responding programs, our respondents identified 72 (2%) of faculty who conducted research for more than 50% of their time. Most respondents (57%) indicated that their groups received less than $500,000 in research funding, whereas 11 (22%) indicated that they received over $1 million in funding. Seven programs indicated that they had either a research fellowship or an alternate training program for aspiring hospitalist investigators. Respondents noted difficulties at every stage of the research development pipeline, from a lack of mentors to run a fellowship program to a lack of applicants seeking further research training.Our analysis of the NIH, AHRQ, and PCORI databases suggested that funding per SHM member may have decreased over time, with a mean estimate of $10,375 per member in fiscal year 2019, compared to $14,642 per member in fiscal year 2010 (β = -0.403, p = 0.053; Figure 1). Publications per member per year decreased over time, from a mean estimate of 1.81 indexed publications in calendar year 2010 to 1.67 indexed publications in calendar year 2019 (β = -0.016, p=0.004; Figure 2).
Conclusions: Despite the continued growth of Hospital Medicine as a field, our profession’s footprint as a research specialty does not appear to be growing. Improvements to our research training pipeline will be essential to the long-term improvement of our profession.
