title: Longitudinal study of in-hospital consultations with neurology in a tertiary hospital. A health care activity on the increase.
abstract: OBJECTIVE
  In-hospital consultation (IHC) is a service that some medical specialties provide to others with the aim of resolving complications in patients admitted to different hospital units. The aim of this study is to perform a descriptive analysis and longitudinal study of IHCs received in our department during the last 5 years.
  
  
  METHODS
  A retrospective study was conducted on the IHCs made within the period 2005-2009. The data analysed were as follows: department of origin of the IHC, reason for consult, date, priority of care, definitive diagnosis, need for follow-up, need for transfer, and the demographic data of the patients.
  
  
  RESULTS
  There were a total of 1458 IHCs in the period studied. The mean age of the patients was 58.2 ± 19.10 years, and 837 (57.6%) were males. The number of IHCs per year was: 2005: 263; 2006: 226; 2007: 239; 2007: 239, 2008: 329 and 2009: 401. The majority (86.8%) had normal priority, 8.5% high priority, and 4.7% were urgent. The Emergency Department (12%), Cardiology (10.9%), General Medicine (9.8%) and Psychiatry (8.9%) were the services with the highest demand. The most frequent reasons for consulting were loss of consciousness and epileptic seizures (24.6%), cerebral vascular disease (21.1%), and confusional states and cognitive impairment (13.4%). Over one third (36.8%) were resolved in the first consultation, and the remainder (63.8%) required follow up. Of all the cases assessed, 8.4% required transfer to Neurology.
  
  
  CONCLUSIONS
  IHC is a complex activity that may not resolve all questions in a single visit. It involves a health care burden which is increasing annually. The increasing diagnostic complexity of the neurology, as well as the increasingly more specific treatments are the factors that lead to this higher demand.
authors.affiliation: Sección de Neurología, Hospital Universitario Infanta Cristina, Badajoz, España. jramirezm@meditex.es
authors.forename: J M
authors.initials: JM
authors.lastname: Ramírez-Moreno
authors.forename: A
authors.initials: A
authors.lastname: Ollero-Ortiz
authors.forename: M J
authors.initials: MJ
authors.lastname: Gómez-Baquero
authors.forename: A
authors.initials: A
authors.lastname: Roa-Montero
authors.forename: A B
authors.initials: AB
authors.lastname: Constantino Silva
authors.forename: F J
authors.initials: FJ
authors.lastname: Hernández Ramos
mesh_terms: D004282:Documentation; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D008137:Longitudinal Studies; D009422:Nervous System Diseases / Q000628:therapy*; D009462:Neurology; D012017:Referral and Consultation / Q000706:statistics & numerical data* / Q000639:trends*; D012189:Retrospective Studies; D013030:Spain; D062606:Tertiary Care Centers