1. Effect of comanagement with internal medicine on hospital stay of patients admitted to the Service of Otolaryngology.
- Author
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Montero Ruiz E, Rebollar Merino Á, Rivera Rodríguez T, García Sánchez M, Agudo Alonso R, and Barbero Allende JM
- Subjects
- Adolescent, Adult, Aged, Emergency Service, Hospital statistics & numerical data, Female, Hospitals, University economics, Hospitals, University organization & administration, Humans, International Classification of Diseases, Male, Middle Aged, Otorhinolaryngologic Surgical Procedures statistics & numerical data, Retrospective Studies, Spain, Young Adult, Hospital Departments organization & administration, Internal Medicine organization & administration, Length of Stay economics, Length of Stay statistics & numerical data, Otolaryngology organization & administration
- Abstract
Introduction and Objectives: Patients admitted to the Department of Otolaryngology (ENT) are increasing in age, comorbidity and complexity, leading to increased consultations/referrals to Internal Medicine (IM). An alternative to consultations/referrals is co-management. We studied the effect of co-management on length of stay (LoS) in hospital for patients admitted to ENT., Methods: This was a retrospective observational study including patients ≥14 years old discharged from ENT between 1/1/2009 and 30/06/2013, with co-management from May/2011. We analysed age, sex, type of admission, whether the patient was operated, administrative weight associated with DRG, total number of discharge diagnoses, Charlson comorbidity index (CCI), deaths, readmissions and LoS., Results: There were statistically significant differences between both groups in age (4.5 years; 95% confidence interval [95% CI] 2.8-6.3), emergency admissions (odds ratio [OR] 1.4; 95% CI 1.1-1.8), administrative weight (0.3637; 95% CI 0.0710-0.6564), number of diagnoses (1.3; 95% CI 1-1.6), CCI (0.4; 95% CI 0.2-0.6) and deaths (OR 4.1; 95% CI 1.1-15.7). On adjustment, co-management reduced ENT LoS in hospital by 28.6%, 0.8 days (95% CI 0.1-1.6%; P=.038). This reduction represents an ENT savings of at least €165,893., Conclusions: Co-management patients admitted to ENT are increasing in age, comorbidity and complexity. Co-management is associated with reduced LoS and costs in ENT, similar to those observed in other surgical services., (Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.)
- Published
- 2015
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