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The hospitalist and co-management in multimorbid medical and surgical patients: a position paper from the EFIM multimorbidity working group
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 26 June 2026
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Multimorbidity represents one of the greatest challenges in modern healthcare. Advances in diagnostics and therapeutics have extended survival but also increased the number of patients presenting with multisystem conditions requiring coordinated inpatient management. This position paper from the EFIM Multimorbidity Working Group explores the evolution, current state, and future of hospitalist co-management models in the United States (US) and Europe. In the US, the emergence of hospitalists in the 1990s revolutionized inpatient medicine. Hospitalist-led co-management, defined as shared responsibility between internists and surgical or subspecialty team, has demonstrated consistent benefits, including reduced complications, shorter hospital stays, fewer readmissions, and enhanced patient and provider satisfaction. Success relies on clear role delineation, effective communication, and structured workflows. Evidence from surgical and oncological co-management highlights significant improvements in outcomes and efficiency, establishing hospitalist co-management as a key component of high-value care. In Europe, where internists traditionally provide comprehensive care, co-management has developed alongside integrated care models addressing multimorbidity. Different integrated and multidisciplinary programs exemplify person-centered frameworks, improving patient experience and quality of care. Although European evidence on co-management remains more limited, its expansion in surgical and medical fields illustrates growing recognition of its value. Yet challenges persist: defining accountability, managing workload, and ensuring cultural acceptance among specialties. The integration of digital health tools and artificial intelligence may further enhance its effectiveness, particularly for high-risk populations. At last, hospitalist co-management stands as a transformative model of inpatient medicine, linking efficiency with holistic, patient-centered care and shaping the future of multidisciplinary hospital practice.
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How to Cite
The hospitalist and co-management in multimorbid medical and surgical patients: a position paper from the EFIM multimorbidity working group. (2026). Italian Journal of Medicine. https://doi.org/10.4081/itjm.2026.2511
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