Search

Resumen Objetivo Analizar la actividad de interconsulta (IC) realizada por los servicios de medicina interna (MI), sus aspectos formales, el perfil de la atencion clinica requerida y cuantificar la carga de trabajo que supone. Material y metodo Estudio multicentrico, observacional, prospectivo, sobre enfermos consecutivos hospitalizados atendidos por servicios de MI mediante IC entre el 15 de mayo y el 15 de junio del ano 2016. Se estimo la carga de trabajo relacionada con dicha actividad (1 UT = 10 min). Resultados Se registraron 1.141 IC procedentes de 43 hospitales, edad 69,4 (DE: 16,2) anos, 51,2% hombres. El indice de Charlson fue 2,3 (DE: 2,2). Los motivos de consulta mas frecuentes fueron: valoracion general (27,4%), fiebre (18,1%), disnea (13,6%), trastorno metabolico (9,6%), HTA (6,3%) y sindrome confusional (5,3%). Las UT estimadas fueron 4 (DE: 5,9) para la primera visita y 7,3 (DE: 21,5) para la suma de las sucesivas. Los pacientes quirurgicos fueron mayores (70,6 [DE: 15,9] vs 64,4 [DE: 16,3]; p = 0,0001) y precisaron mas dias de seguimiento (5 [DE: 7,3] vs 3,5 [DE: 4,2]; p = 0,009). Los siguientes aspectos fueron mas frecuentes en el formato de las IC realizadas por servicios medicos: numero de IC ordinarias (respuesta > 24 h), especificacion del motivo de IC, datos minimos referentes a la historia clinica y coincidencia de la adecuacion en el tiempo con el consultor. Conclusion Los pacientes atendidos mediante IC por los servicios de MI representan una carga de trabajo importante. La adecuacion al formato de solicitud de IC es mayor en las procedentes de servicios medicos.

Resumen La interconsulta medica en pacientes hospitalizados constituye una actividad habitual entre los especialistas en medicina interna. Sin embargo, a pesar de su impacto e importancia crecientes, no se ha establecido un modelo que defina sus caracteristicas, sus objetivos o la informacion que debe contener. En este trabajo, desde el Grupo de Asistencia Compartida e Interconsultas de la Sociedad Espanola de Medicina Interna, se proponen unas recomendaciones generales respecto a la forma de solicitar y de responder una interconsulta medica hospitalaria, asi como un formato para la misma.

To analyse the activity of interconsultations conducted by internal medicine (IM) departments, their formal aspects and the profile of clinical care required and to quantify the workload they represent.A multicentre, observational prospective study was conducted with consecutive hospitalised patients treated by IM departments using interconsultations between May 15 and June 15, 2016. We estimated the workload related to this activity (1time unit [TU]=10min).We recorded 1,141 interconsultations from 43 hospitals. The mean age of the patients involved was 69.4 years (SD: 16.2), and 51.2% were men. The mean Charlson index was 2.3 (SD: 2.2). The most common reasons for the consultations were general assessments (27.4%), fever (18.1%), dyspnoea (13.6%), metabolic disorder (9.6%), arterial hypertension (6.3%) and delirium (5.3%). The duration of the first visit was 4 TUs (SD: 5.9) and 7.3 (SD: 21.5) for the sum of all subsequent visits. The surgical patients were older (70.6 [SD, 15.9] vs. 64.4 [SD, 16.3] years; P=.0001) and required more follow-up time (5 [SD, 7.3] vs. 3.5 [SD, 4.2] days; P=.009). The following issues were more common in the interconsultation format performed by medical services: number of regular interconsultations (response24h), specification of the reason for the interconsultation, minimal data regarding the medical history and agreement on the appropriateness of the time spent with the consultant.The patients treated through interconsultations by the IM departments represented a significant workload. The interconsultations from the medical departments were more in line with the request format.

Medical interconsultation for hospitalised patients is a regular activity among internal medicine specialists. However, despite its growing impact and importance, a model that defines its characteristics, objectives and information has not been established. This study, conducted by the Shared Care and Interconsultations Group of the Spanish Society of Internal Medicine, proposes a number of general recommendations concerning the method for requesting and responding to hospital medical interconsultations, as well as a format for these interconsultations.