TY - JOUR T1 - RECALMIN IV. Evolution in the activity of internal medicine units of the National Health System (2008–2021) JO - Revista Clínica Española (English Edition) T2 - AU - Díez-Manglano,J. AU - Carretero-Gómez,J. AU - Chimeno-Viñas,M.M. AU - Martín-Escalante,M.D. AU - Recio-Iglesias,J. AU - Manzano-Espinosa,L. AU - Zapatero-Gaviría,A. AU - del Prado,N. AU - Elola,J. SN - 22548874 M3 - 10.1016/j.rceng.2023.02.001 DO - 10.1016/j.rceng.2023.02.001 UR - https://revclinesp.es/en-recalmin-iv-evolution-in-activity-articulo-S2254887423000231 AB - AimsThis work aims to analyze the structure, activity, and outcomes of internal medicine units and departments (IMU) of the Spanish National Health System (SNHS) and to analyze the challenges for the specialty and propose policies for improvement. It also aims to compare the results from the 2021 RECALMIN survey with IMU surveys from previous years (2008, 2015, 2017, 2019). MethodsThis work is a cross-sectional, descriptive study of IMUs in acute care general hospitals of the SNHS that compares data from 2020 with previous studies. The study variables were collected through an ad hoc questionnaire. ResultsBetween 2014 and 2020, hospital occupancy and discharges by IMU increased (annual mean of 4% and 3.8%, respectively), as did hospital cross-consultation and initial consultation rates (2.1% in both cases). E-consultations increased notably in 2020. Risk-adjusted mortality and length of hospital stay did not show significant changes from 2013−2020. Progress in the implementation of good practices and systematic care for complex chronic patients was limited. A consistent finding in RECALMIN surveys was the variability among IMUs in terms of resources and activity, though no statistically significant differences were found in regard to outcomes. ConclusionsThere is considerable room for improvement in the operation of IMUs. The reduction in unjustified variability in clinical practice and inequities in health outcomes are a challenge for IMU managers and the Spanish Society of Internal Medicine. ER -