Assessment of the in-hospital course after discharge from an internal medicine service

• Autor(a) principal: Dias, Patrícia
• Data de Publicação: 2002
• Outros Autores: Parente, Francisco, Gaspar, Elsa, Carrola, Paulo, Alexandrino, Mário, Alves de Moura, J.J.
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1872
• topic: Avaliação após a alta; readmissões; Post-discharge assessment; readmissions

Introduction and methods – Post-discharge follow-up and use of institution resources may be important indicators in the evaluation of a Services’ activity. The authors have retrospectively analyzed some post-discharge assessment parameters in an Internal Medicine Service.Material and Methods – Admissions to the Medicina II Service of the Coimbra University Hospital, who were discharged, as registered on the DRG data-base, , during a 3 month period were selected. Thepatients’ course inside the institution in the following 6 months was studied. Demographic data,outpatient visits, emergency visits and readmissions were analyzed, as were mortality, principaldiagnosis, DRG and its relative weight.Results – 72.9% of all patients had at least one post-discharge contact (outpatient visit, emergency visit, readmission). There were 232 outpatient visits (54.2% of patients), 100 emergency visits (41.6%) and 86 readmissions (41%); of the latter, the most frequent principal diagnosis was pneumonia (10,4%). The mortality rate was 10.4% (15 patients). Some factors influenced the results, like a relative weight over 1.0 and age under 80, which influenced the number of patients with outpatient visits, as well as thediagnosis of pneumonia, which influenced the number of patients with emergency visits and mortality.Conclusions – This study shows a significant impact of the post-discharge care in the same institution, in its diverse sectors. The in-hospital mortality was probably the most important result, revealing thegeneral prognosis of our inpatients. The systematic review of post-discharge assessment parameters,including in-hospital mortality and readmissions is important to overcome the difficulties in today’sInternal Medicine Services. It is necessary, in these studies, to use comparable methods, like DRGs and case-mix.