title: [Fast specialized ambulatory care of medical disease in an urban tertiary university hospital. Fast care consultation].
abstract: BACKGROUND
  The experience of an urban tertiary university hospital in the design and establishment of Specialized Ambulatory Consultation (SAC) of Internal Medicine is presented. The purpose of this consultation is fast specialized ambulatory care of medical diseases, decrease of inappropriate hospitalizations and improvement of coordination with primary health care.
  
  
  METHODS
  Systematic collection of the following variables in all the patients who visited the SAC between March 2006 and February 2007: origin, syndromic diagnosis and reason for consultation, age and gender, number of visits, examinations made, and destination on discharge. The descriptive statistical analysis was made in March 2007.
  
  
  RESULTS
  A total of 744 patients with 1248 visits were seen (successive/first ratio of 0.67). Mean age was 62.56 (18.6) years and 50.6% were women. The hospital origin/primary origin went from 3.5 - 4 in the first quarter to between 2.6 - 2.8 in the last quarter. The main reasons for consultation due to patient with constitutional or anemic syndromes with suspicion of serious disease and patients with decompensation of chronic diseases or infectious disease. Half of the patients returned to primary care and the rest were distributed among different hospital resources. It stands out that 30% were sent to the hospital consultations and 10% required hospitalization or transfer to the emergency room.
  
  
  CONCLUSIONS
  The SAC is a Fast Consultation Care (diagnosis and treatment) of general internal medicine located in a tertiary university hospital with a good capacity of resolution. It facilitates Specialized Ambulatory Care of medical diseases, decreasing inappropriate hospitalization and improving coordination with the Primary Health Care.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Valle Hebrón, Barcelona, España. asanjose@vhebron.net
authors.forename: A
authors.initials: A
authors.lastname: San José Laporte
authors.forename: X
authors.initials: X
authors.lastname: Jiménez Moreno
authors.forename: I
authors.initials: I
authors.lastname: Ligüerre Casals
authors.forename: M C
authors.initials: MC
authors.lastname: Vélez Miranda
authors.forename: M
authors.initials: M
authors.lastname: Vilardell Tarrés
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data*; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013038:Specialization; D013997:Time Factors