Quick diagnosis units versus hospitalization for the diagnosis of potentially severe diseases in Spain

✍ Scribed by Xavier Bosch; Anna Jordán; Antonio Coca; Alfonso López-Soto

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 154 KB
• Volume: 7
• Category: Article
• ISSN: 1553-5592
• DOI: 10.1002/jhm.931

✦ Synopsis

Abstract

OBJECTIVES:

We describe the functioning of a quick diagnosis unit (QDU) in a Spanish public university hospital to ascertain the utility and cost of the model compared to conventional hospitalization.

DESIGN:

Observational study with a prospective and retrospective cohort.

SETTING:

Spanish tertiary public university hospital.

PATIENTS:

Two thousand consecutive patients evaluated between December 2007 and July 2010 with potentially severe diseases normally requiring hospitalization for diagnosis. For comparative purposes, we analyzed a randomized, retrospective cohort of 1454 hospitalized patients.

MEASUREMENTS:

Variables measured included source of referral, reason for consultation, time to diagnosis and length‐of‐stay, hospitalizations avoided, Charlson comorbidity index, costs, and patient satisfaction using a telephone survey.

RESULTS:

Suspected anemia, cachexia‐anorexia syndrome, febrile syndrome, adenopathies and/or palpable masses, abdominal pain, diarrhea, and lung abnormalities accounted for 88% of QDU patients. The most‐frequent diagnoses were cancer (26.3%) and iron‐deficiency anemia. QDU patients with anemia were significantly younger than hospitalized patients with the same diagnosis (P < 0.0001). Other parameters were similar between QDU and hospitalized patients. The mean cost of treatment was 3153.87 Euros for hospitalization and 702.33 Euros for the QDU. Patients expressed a high degree of satisfaction with QDU care.

CONCLUSIONS:

QDUs can manage the diagnosis of patients with potentially severe diseases equally as well as traditional hospitalization, and saves costs. QDU patients expressed a high degree of satisfaction, with most preferring this model to hospitalization. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine