Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.
We examined trends in resource use and patient characteristics over the study period.
RESULTS: There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%).
INTERPRETATION: Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system.
PMID: 29237706 [PubMed]
Source: cmaj - Category: General Medicine Authors: Verma AA, Guo Y, Kwan JL, Lapointe-Shaw L, Rawal S, Tang T, Weinerman A, Cram P, Dhalla IA, Hwang SW, Laupacis A, Mamdani MM, Shadowitz S, Upshur R, Reid RJ, Razak F Tags: CMAJ Open Source Type: research
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