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Quick diagnosis units versus hospitalization for the diagnosis of potentially severe diseases in Spain
Author(s) -
Bosch Xavier,
Jordán Anna,
Coca Antonio,
LópezSoto Alfonso
Publication year - 2012
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.931
Subject(s) - medicine , retrospective cohort study , medical diagnosis , anemia , referral , pediatrics , comorbidity , emergency medicine , intensive care medicine , family medicine , pathology
OBJECTIVES: We describe the functioning of a quick diagnosis unit (QDU) in a Spanish public university hospital to ascertain the utility and cost of the model compared to conventional hospitalization. DESIGN: Observational study with a prospective and retrospective cohort. SETTING: Spanish tertiary public university hospital. PATIENTS: Two thousand consecutive patients evaluated between December 2007 and July 2010 with potentially severe diseases normally requiring hospitalization for diagnosis. For comparative purposes, we analyzed a randomized, retrospective cohort of 1454 hospitalized patients. MEASUREMENTS: Variables measured included source of referral, reason for consultation, time to diagnosis and length‐of‐stay, hospitalizations avoided, Charlson comorbidity index, costs, and patient satisfaction using a telephone survey. RESULTS: Suspected anemia, cachexia‐anorexia syndrome, febrile syndrome, adenopathies and/or palpable masses, abdominal pain, diarrhea, and lung abnormalities accounted for 88% of QDU patients. The most‐frequent diagnoses were cancer (26.3%) and iron‐deficiency anemia. QDU patients with anemia were significantly younger than hospitalized patients with the same diagnosis ( P < 0.0001). Other parameters were similar between QDU and hospitalized patients. The mean cost of treatment was 3153.87 Euros for hospitalization and 702.33 Euros for the QDU. Patients expressed a high degree of satisfaction with QDU care. CONCLUSIONS: QDUs can manage the diagnosis of patients with potentially severe diseases equally as well as traditional hospitalization, and saves costs. QDU patients expressed a high degree of satisfaction, with most preferring this model to hospitalization. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine