Evaluación de las consultas de atención inmediata en Medicina Interna (Hospital Clínico Universitario de Valladolid)

Study on the inmediate care clinics of the Internal Medicine Department (Universitary Clinic Hospital of Valladolid)

P Á. de Santos Castroa, A. Jimeno Carrúeza, M C. García Coboa, M I. Elices Calzóna, A. Almaraz Gómezb, M F. Muñoz Morenob

a Servicio de Medicina Interna. Hospital Clínico Universitario. Valladolid.

b Unidad de Apoyo a la Investigación. Hospital Clínico Universitario. Valladolid.

Background. Several studies have found a high percentage of inadequate admissions to Internal Medicine Departments. In order to try to alleviate this situation, the Immediate Care Clinics of the Internal Medicine Department (ICCIMD) was created, to study those patients who are suspected of having a serious disease, and whose physical condition allows them to undergo an out-patient study the day after having visited the Emergency Department. The tests requested will take precedence over the rest of the consultations. Methods. Descriptive, retrospective study, through the review of the clinical records of the patients who came to the ICCIMD during the first two years. Results. Our service admitted 726 people in the ACCIMD, 52.2 % males, average age of 54.12 years old. A total of 18.6 % of the patients required hospital admission; this admission being carried out at the first medical examination in 66.7% of the cases. In most cases, it can be related with shortening a study that would have lasted longer. In spite of this, we consider that 1.4 daily admissions have been avoided. Mean time devoted to this study was about 33.20 days, much greater than that expected, because of the high prevalence of non-specific disease and hospital organization deficit. It was decided to study 76.6% of the patients sent, their diagnosis being achieved in 63.3% of the total number of patients. Nevertheless, the ICCIMD was inadequate, as hospital admission was required or the patient was sent to other specialities in the 27.3% of the cases. Conclusions. We think that the ACCIMD can be useful to improve efficiency of Internal Medicine Department, although, to do so, the significant problems found must be solved.

Keywords:

alternative to hospitalitation, inadequate admission, early diagnostic, outpatient department, efficiency of hospital