title: Effect of co-management with Internal Medicine on hospital stay in Ophthalmology.
abstract: OBJECTIVE
  Patients admitted to the Department of Ophthalmology (OPH) are of increasing age, comorbidity and complexity, leading to increased consultations/referrals to Internal Medicine (IM). An alternative to consultations/referrals is co-management. The effect of co-management on length of hospital stay was studied in patients admitted to OPH.
  
  
  METHODS
  Retrospective observational study was performed that included patients ≥14 years old discharged from OPH between 1 January 2009 and 30 June 2013, who were co-managed from May 2011. An analysis was made including age, sex, type of admission, whether it was operated on, administrative weight associated with GRD, total number of discharge diagnoses, Charlson comorbidity index (CCI), mortality, readmissions, and LoS.
  
  
  RESULTS
  There were statistically significant differences between the groups in operated patients (odds ratio [OR] 2.3, 95% confidence interval [95% CI] 1.5 to 3.6), administrative weight (0.1160; 95% CI 0.0738 to 0.1583), and number of diagnoses (0.9, 95% CI 0.5 to 1.3). On adjustment, co-management reduced LoS in OPH by 27.8%, 0.5 days (95% CI 0.1 to 1).
  
  
  CONCLUSIONS
  Patients admitted to OPH have increasing comorbidity and complexity. Co-management is associated with a reduced LoS and costs in OPH, similar to that observed in other surgical services.
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 Oftalmología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
authors.forename: M A
authors.initials: MA
authors.lastname: Castejón Cervero
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: 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: M
authors.initials: M
authors.lastname: García Sánchez
mesh_terms: D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007388:Internal Medicine / Q000458:organization & administration*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000706:statistics & numerical data; D009885:Ophthalmology / Q000458:organization & administration* / Q000706:statistics & numerical data; D010343:Patient Admission; D010351:Patient Discharge; D010359:Patient Readmission; D012017:Referral and Consultation / Q000458:organization & administration* / Q000706:statistics & numerical data; D012189:Retrospective Studies
keywords: Asistencia compartida; Co-management; Internal Medicine; Medicina Interna; Oftalmología; Ophthalmology; Referral and consultation; Remisión y consulta