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BMC Research Notes

, 1:96

First Online: 28 October 2008Received: 08 August 2008Accepted: 28 October 2008DOI: 10.1186-1756-0500-1-96

Cite this article as: Jordan, M.R., Conley, J. & Ghali, W.A. BMC Res Notes 2008 1: 96. doi:10.1186-1756-0500-1-96


BackgroundConsultation in hospital is an essential tool for acquiring subspecialty support when managing patients. There is limited knowledge on the utilization of subspecialty consultation from hospital based general internists. Consultation patterns to medical subspecialists and the patient factors that may influence consultation are reported for general medical services.

Methods and findingsHospital discharge data were obtained for patients from medical services over a 2-year period. Consultations requested to medicine subspecialties were identified, and then reported by type and frequency. Information on demographic factors, clinical diagnoses, length of stay LOS, time in critical care units, and disposition were compared for patients with and without consultation.

3979 patients were hospitalized during the study and 2885 consultations occurred. Almost half of the patients received at least one consultation 48.3%. Gastroenterology 26.3%, infectious diseases 14.6% and respirology 13.6% were the most frequently consulted services. Patients with consultation had a greater number of total diagnoses 7.3 vs. 5.5, P < 0.001, a greater mean LOS 15.9 vs. 6.8 days, were more likely to spend time in the ICU 11.5% vs. 3.5% and CCU 4.3% vs. 1.2%, and to expire in hospital 10.7% vs. 4.9%.

ConclusionConsultation occurs frequently and its presence is an indicator of patient complexity and high use of health system resources. Analysis of consultation patterns for specific patient populations could assist in optimizing efficiency in health care delivery. Targeting quality improvement strategies toward optimizing consultation processes, engaging heavily utilized subspecialties in educational roles and assisting with resource planning are areas for future consideration.

Electronic supplementary materialThe online version of this article doi:10.1186-1756-0500-1-96 contains supplementary material, which is available to authorized users.

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Autor: Michaela R Jordan - Joslyn Conley - William A Ghali


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