A quick diagnosis unit as an alternative to conventional hospitalization in a tertiary public hospital: a descriptive study.
BACKGROUND
Reports indicate that a significant number of patients admitted to internal medicine units could be studied on an outpatient basis.


OBJECTIVE
This article assesses a quick diagnosis unit (QDU) as an alternative to acute hospitalization for the diagnostic study of patients with potentially serious diseases and suspected malignancy.


METHODS
Between March 2008 and June 2012, 1226 patients were attended by the QDU. Patients were referred from the emergency department, primary health care centers, and outpatient clinics according to well‑defined criteria. Clinical information was prospectively registered in a database.


RESULTS
There were 634 men (51.7%), with a mean age of 60.5 ±17.5 years. The mean time to the first visit was 3.5 ±5.3 days. Most patients (65.7%) required only 2 visits. The mean interval to diagnosis was 12.2 ±14.7 days. A total of 324 patients (26.4%) had cancer. The diagnosis was  solid tumor in 81.5% of the cases, lymphoma in 19.8%, and various hematologic malignancies in 4.3%. The second most common diagnosis was anemia not associated with cancer (8.6% of the cases). Admission to the QDU allowed to avoid conventional hospitalization for diagnostic studies in 71.5% of the patients, representing a mean freeing‑up rate of 7 internal medicine beds per day. In a satisfaction survey, 97% of the patients were completely or very satisfied and 96% preferred the QDU to conventional hospitalization.


CONCLUSIONS
A QDU may be a feasible alternative to conventional hospitalization for the diagnosis of otherwise healthy patients with suspected severe disease. Appropriately managed and supported, QDUs can lighten the burden of emergency departments and reduce the need for hospitals beds.
Carmen
C
Sanclemente-Ansó
Albert
A
Salazar
Xavier
X
Bosch
Cristina
C
Capdevila
Antoni
A
Vallano
Isabel
I
Català
Antonio F
AF
Fernandez-Alarza
Beatriz
B
Rosón
Xavier
X
Corbella
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000706:statistics & numerical data; D000740:Anemia / Q000175:diagnosis*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000175:diagnosis*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011044:Poland; D012017:Referral and Consultation / Q000458:organization & administration* / Q000706:statistics & numerical data; D062606:Tertiary Care Centers / Q000458:organization & administration; D055815:Young Adult