Trends in Hospitalization of Patients with Potentially Serious Diseases Evaluated at a Quick Diagnosis Clinic

Although quick diagnosis units (QDU) have become a cost-effective alternative to inpatient admission for diagnosis of potentially serious diseases, the rate of return hospitalizations among evaluated patients is unknown. This study examined the temporal trends in admissions of QDU patients through 1...

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Main Authors: Xavier Bosch, Andrea Ladino, Pedro Moreno-Lozano, Anna Jordán, Alfonso López-Soto
Format: Article
Language:English
Published: MDPI AG 2020-08-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/10/8/585
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spelling doaj-b5d24b5835f44a9eb48b66bf313c19c52020-11-25T03:16:27ZengMDPI AGDiagnostics2075-44182020-08-011058558510.3390/diagnostics10080585Trends in Hospitalization of Patients with Potentially Serious Diseases Evaluated at a Quick Diagnosis ClinicXavier Bosch0Andrea Ladino1Pedro Moreno-Lozano2Anna Jordán3Alfonso López-Soto4Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Hospital Clínic, 08036 Barcelona, SpainDepartment of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Hospital Clínic, 08036 Barcelona, SpainDepartment of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Hospital Clínic, 08036 Barcelona, SpainDepartment of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Hospital Clínic, 08036 Barcelona, SpainDepartment of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Hospital Clínic, 08036 Barcelona, SpainAlthough quick diagnosis units (QDU) have become a cost-effective alternative to inpatient admission for diagnosis of potentially serious diseases, the rate of return hospitalizations among evaluated patients is unknown. This study examined the temporal trends in admissions of QDU patients through 15 years. Adult patients referred to QDU from 2004 to 2019 who were hospitalized between the first and last visit in the unit were eligible. Decisions about admissions were mainly based on the Appropriateness Evaluation Protocol and required independent validation by experienced clinicians using a customized tool. The final analysis included 825 patients. Patient characteristics and major reasons for admission were compared each year and linear trends were analyzed. Admission rates decreased from 7.2% in 2004–2005 to 4.3% in 2018–2019 (<i>p</i> < 0.0001). While a significant increasing trend was observed in the rate of admissions due to cancer-related complications (from 39.5% in 2004–2005 to 61.7% in 2018–2019; <i>p</i> < 0.0001), those due to anemia-related complications and scheduled invasive procedures experienced a significant downward trend. A likely explanation for these declining trends was the relocation of the unit to a new daycare center in 2013–2014 with recovery rooms and armchairs for IV treatments. The facts of this study could help in the provision of anticipatory guidance for the optimal management of patients at risk of clinical complications.https://www.mdpi.com/2075-4418/10/8/585trends in hospitalizationquick diagnosis unitsdiagnosishospital ambulatory medicinecanceranemia
collection DOAJ
language English
format Article
sources DOAJ
author Xavier Bosch
Andrea Ladino
Pedro Moreno-Lozano
Anna Jordán
Alfonso López-Soto
spellingShingle Xavier Bosch
Andrea Ladino
Pedro Moreno-Lozano
Anna Jordán
Alfonso López-Soto
Trends in Hospitalization of Patients with Potentially Serious Diseases Evaluated at a Quick Diagnosis Clinic
Diagnostics
trends in hospitalization
quick diagnosis units
diagnosis
hospital ambulatory medicine
cancer
anemia
author_facet Xavier Bosch
Andrea Ladino
Pedro Moreno-Lozano
Anna Jordán
Alfonso López-Soto
author_sort Xavier Bosch
title Trends in Hospitalization of Patients with Potentially Serious Diseases Evaluated at a Quick Diagnosis Clinic
title_short Trends in Hospitalization of Patients with Potentially Serious Diseases Evaluated at a Quick Diagnosis Clinic
title_full Trends in Hospitalization of Patients with Potentially Serious Diseases Evaluated at a Quick Diagnosis Clinic
title_fullStr Trends in Hospitalization of Patients with Potentially Serious Diseases Evaluated at a Quick Diagnosis Clinic
title_full_unstemmed Trends in Hospitalization of Patients with Potentially Serious Diseases Evaluated at a Quick Diagnosis Clinic
title_sort trends in hospitalization of patients with potentially serious diseases evaluated at a quick diagnosis clinic
publisher MDPI AG
series Diagnostics
issn 2075-4418
publishDate 2020-08-01
description Although quick diagnosis units (QDU) have become a cost-effective alternative to inpatient admission for diagnosis of potentially serious diseases, the rate of return hospitalizations among evaluated patients is unknown. This study examined the temporal trends in admissions of QDU patients through 15 years. Adult patients referred to QDU from 2004 to 2019 who were hospitalized between the first and last visit in the unit were eligible. Decisions about admissions were mainly based on the Appropriateness Evaluation Protocol and required independent validation by experienced clinicians using a customized tool. The final analysis included 825 patients. Patient characteristics and major reasons for admission were compared each year and linear trends were analyzed. Admission rates decreased from 7.2% in 2004–2005 to 4.3% in 2018–2019 (<i>p</i> < 0.0001). While a significant increasing trend was observed in the rate of admissions due to cancer-related complications (from 39.5% in 2004–2005 to 61.7% in 2018–2019; <i>p</i> < 0.0001), those due to anemia-related complications and scheduled invasive procedures experienced a significant downward trend. A likely explanation for these declining trends was the relocation of the unit to a new daycare center in 2013–2014 with recovery rooms and armchairs for IV treatments. The facts of this study could help in the provision of anticipatory guidance for the optimal management of patients at risk of clinical complications.
topic trends in hospitalization
quick diagnosis units
diagnosis
hospital ambulatory medicine
cancer
anemia
url https://www.mdpi.com/2075-4418/10/8/585
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