title: Analysis of in-hospital consultations with the department of internal medicine.
abstract: OBJECTIVE
  An important but understudied activity of the departments of internal medicine (IM) is the in-hospital consultations. We analyzed the requests for in-hospital consultation with IM and the potential differences between the consultations of medical and surgical departments.
  
  
  METHODS
  This was an 8-month observational prospective study that analyzed demographic variables related to the origin of the interconsultation, comorbidity, length of stay and hospital mortality, emergency, admission-consultation request delay, appropriateness (not appropriate if another department was consulted for the same reason or if the pathology behind the consultation was that of the requesting service) and, for patients who underwent surgery, whether it was requested before or after the surgery.
  
  
  RESULTS
  During the study, 215 in-hospital consultations were conducted (27 consultations/month). The mean age of the patients was 69.8 years (women, 50%). Some 30.7% were requested by medical departments and 69.3% by surgical departments. Thirteen percent of the in-hospital consultations were duplicated. The department of IM was not the appropriate department consulted in 23.3% of cases (13.0% of the cases requested consultations for the same reason with another department; in 14.3% of the cases, the pathology was that of requesting department). More in-hospital consultations were conducted on Mondays and Fridays than on Thursdays (25.1% and 23.7% versus 15.3%, respectively; p=.03). The delay between admission and the request for interconsultation was of 12.6 days. Some 90.7% of the in-hospital consultations for patients undergoing surgery were requested after the intervention. There were no differences in the characteristics of the in-hospital consultations between the medical and surgical departments.
  
  
  CONCLUSIONS
  In-hospital consultations directed at IM are frequently duplicate, are not well directed at the appropriate department and their urgency is incorrectly assessed. These characteristics are similar for the consultations with medical and surgical departments.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España. Electronic address: eduardo.montero@salud.madrid.org.
authors.forename: E
authors.initials: E
authors.lastname: Montero Ruiz
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Rebollar Merino
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: García Sánchez
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Culebras López
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Barbero Allende
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: López Álvarez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006748:Hospital Departments / Q000458:organization & administration / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine / Q000458:organization & administration / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013997:Time Factors
keywords: Admitted patients; Departamento de cirugía; Department of surgery; Internal medicine; Medicina interna; Pacientes ingresados; Remisión y consulta; Remission and consultation