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[影响外科与内科之间科室间转诊的因素]

[Factors that influence interdepartmental referrals between Surgical Departments and Internal Medicine].

作者信息

Montero Ruiz Eduardo, Pérez Sánchez Laura, Gómez Ayerbe Cristina, Barbero Allende José María, García Sánchez Marta, López Álvarez Joaquín

机构信息

Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.

出版信息

Cir Esp. 2011 Feb;89(2):106-11. doi: 10.1016/j.ciresp.2010.12.008. Epub 2011 Feb 1.

Abstract

INTRODUCTION

To analyse the long term outcome of the age and comorbidity of patients admitted to Surgical Departments, the number of referrals to Internal Medicine made by these Departments, and to assess whether there are seasonal variations and the call/reject effect.

MATERIAL AND METHODS

We compared the age, Charlson Comorbidity Index (CCI), and the number of referrals made by Traumatology, General Surgery and Urology of patients discharged in 2000, with those discharged in 2007. Seasonal variations and the call/reject effect were studied by analysing all the interdepartmental referrals made by all the surgical departments from the year 2000 to 2007.

RESULTS

Age increased by 5.6% between 2000 and 2007, the CCI by 5.8%, and interdepartmental referrals by 60%. Interdepartmental referrals decreased in July and August, whilst they increased in January, February, June and October, up to 64% more in January, although with variations of almost 50% in the same month. We detected differences of up to 68.2% in the referrals requested to different physicians.

CONCLUSIONS

We observed a sharp increase in the requests for referral to Internal Medicine by Surgical Departments of our hospital, which is not explained by the increase in admissions to these Departments, and which could be associated with the increase in age and comorbidity of their patients. Requests for interdepartmental referral have marked monthly variations and also as regards the Consulting Physician.

摘要

引言

为分析外科住院患者的年龄及合并症的长期转归、外科科室向内科的转诊数量,并评估是否存在季节性变化及呼叫/拒绝效应。

材料与方法

我们比较了2000年出院的创伤科、普通外科和泌尿外科患者与2007年出院患者的年龄、查尔森合并症指数(CCI)及转诊数量。通过分析2000年至2007年所有外科科室的所有跨科室转诊情况,研究季节性变化及呼叫/拒绝效应。

结果

2000年至2007年期间,年龄增长了5.6%,CCI增长了5.8%,跨科室转诊增加了60%。跨科室转诊在7月和8月减少,而在1月、2月、6月和10月增加,1月增加幅度高达64%,尽管同月变化幅度近50%。我们发现向不同医生的转诊请求差异高达68.2%。

结论

我们观察到我院外科科室向内科的转诊请求急剧增加,这并非由这些科室住院人数的增加所解释,可能与患者年龄及合并症的增加有关。跨科室转诊请求存在明显的月度变化,在咨询医生方面也存在差异。

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