[Effect derived by the adscription of internist to a surgical department].
OBJECTIVE
Although surgical units commonly request the collaboration of internists via medical consultation, the efficiency of this system is low and expensive. We studied the effect of the integration of full-time internists in a surgical department.


METHODS
The study group consisted of the patients admitted during intervention in the Orthopedic Surgery and Traumatology Department. Those patients admitted during the same period of the previous year made up the control group. We analyzed pre-surgical stay, post-surgical stay and total stay. We also studied in-hospital mortality, re-admissions and those patients who were not submitted to surgery (NSS). Control variables were age, sex, type of admission (programmed/emergency) and main diagnosis.


RESULTS
1,216 patients were included, 599 in the control group and 617 in the study group, 48.0% were emergency admissions and 11.7% NSS patients. Study of programmed patients did not suggest any differences between both groups in any of the analyzed variables. In emergency patients, the total stay was decreased in 18.2%, and it was reduced in 40.2% of the NSS. The distribution of the re-admissions was similar in both study and control groups. We observed a decrease in the NSS and a 50% decrease in the deaths of the study group. The obtained saving was 329,170 Euros.


CONCLUSIONS
The adscription of full-time internists to a surgical service clearly improves the quality of the service it provides, with important hospital savings.
Montero Ruiz
Eduardo
E
Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España. emonteror@wanadooadsl.net
Hernández Ahijado
Concepción
C
López Alvarez
Joaquín
J
D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D013030:Spain; D013503:Surgery Department, Hospital / Q000191:economics*; D000078329:Workforce