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Rev Clin Esp. 2017 Nov;217(8):446-453. doi: 10.1016/j.rce.2017.07.008. Epub 2017 Aug 30.

RECALMIN II. Eight years of hospitalisation in Internal Medicine Units (2007-2014). What has changed?

[Article in English, Spanish]

Author information

1
Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, España. Electronic address: antonio.zapatero@salud.madrid.org.
2
Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos Móstoles, Madrid, España.
3
Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, España.
4
Servicio de Medicina Preventiva, Hospital Clínico Universitario San Carlos, Madrid, España.
5
Servicio de Medicina Interna, Hospital Universitario Regional de Málaga, Málaga, España.
6
Unidad de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, España.
7
Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, España.
8
Servicio de Medicina Interna, Hospital Clínico Universitario San Carlos, Madrid, España.
9
Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, España.

Abstract

OBJECTIVES:

To analyse the evolution of care provided by the internal medicine units (IMU) of the Spanish National Health System from 2007 to 2014.

MATERIAL AND METHODS:

We analysed all discharges from the IMU of the Spanish National Health System in 2007 and 2014, using the Minimum Basic Data Set. We compared the risk factors by episode, mortality and readmissions between the two periods. We prepared specific fits for the risk for mortality and readmissions in heart failure, pneumonia and chronic obstructive pulmonary disease, as well as the Charlson index for all activity.

RESULTS:

Discharges from the IMU between the two periods increased 14%. The average patient age increased by 2.8 years (71.2±17.1 vs. 74±16.2; p<.001), with a marked increase in comorbidity (Charlson index, 4±3.7 vs. 4.7±3.9; p<.001; 24% increase in risk factors per episode). The adjusted mortality rates decreased slight but significantly, with a slight increase in readmissions.

CONCLUSIONS:

During the analysed period, there was an increase of almost 3 years in the mean age of patients treated in the IMU of the Spanish National Health System, with a marked increase in comorbidity. These results should lead to a more appropriate assignment of nurse workloads and an increased implementation of good practices in clinical management.

KEYWORDS:

Calidad; Indicadores; Indicators; Internal Medicine; Medicina Interna; Quality

PMID:
28851485
DOI:
10.1016/j.rce.2017.07.008

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