[Clinical processes in a high resolution clinic of specialist outpatient clinics]. / Procesos médicos susceptibles de alta resolución en consultas ambulatorias.

OBJECTIVES: The high resolution clinic (HRC) is an outpatient care process by which treatment and diagnosis are established, recorded, and completed in a single day. The aim of this study was to assess the extent to which patients with medical conditions may benefit from a single consultation system. MATERIAL AND METHODS: A descriptive study of 795 first visit events, randomly selected as high-resolution consultations in cardiology, gastroenterology, internal medicine, and chest diseases. A discussion is presented on the percentage of patients who benefited from HRC and the complementary tests performed. RESULTS: A total of 559 (70%, 95% CI: 67-73%) of all first visits became HRCs, and 483 (61%, 95% CI: 57%-64%) required a diagnostic test that was reviewed on the same day. There were differences between medical consultations (86% in cardiology versus 44% in gastroenterology consultations, P<.001). Performing a test on the same day significantly increased the percentage of HRCs (49 versus 22%, P<.001). Ischaemic heart disease, dyspepsia, headache, and asthma were the conditions most commonly leading to HRC. The most common tests were cranial tomography, blood analysis, and ultrasound. CONCLUSIONS: Medical consultations may largely benefit from an HRC system, only requiring some organisational changes and no additional costs.

[Characteristics of patients with multiple disease hospitalized in Internal Medicine services]. / Características clínicas diferenciales de los enfermos pluripatológicos hospitalizadosen servicios de Medicina Interna.

INTRODUCTION: Know what proportion of patients hospitalized in the Internal Medicine services have multiple diseases. MATERIAL AND METHODS: We analyzed 400 clinical histories of a random sample of patients admitted to 24 Internal Medicine services of Andalusia. We assessed the diagnostic categories present that make it possible to classify patients as having multiple diseases. RESULTS: One hundred sixty eight patients (42%) were considered as having multiple diseases. The most prevalent diseases in these patients are cardiological and diabetes mellitus. The two main variables that determine that one is a multiple disease patient are age and disease causing the admission. DISCUSSION: A significant percentage of the patients admitted to the Medicine services of the Andalusia public hospitals have multiple diseases.

[The practice of Internal Medicine in Andalusia follows the evidence-based medicine basic principles]. / La práctica de la Medicina interna en Andalucía se ajusta a la Medicina basada en la evidencia.

BASIS: To know the proportion of medical interventions carried out in the Services of Internal Medicine of the public hospitals of Andalusia based on randomized clinical trials. PATIENTS AND METHODS: We have analyzed the primary treatments prescribed in a random sample of 326 patients admitted to these Internal Medicine services during 1998. RESULTS: One hundred and forty-three of the 326 treatments analyzed (43.9%) were based in clinical trials and 135 (41.4%) were interventions unanimously accepted by the medical community without being based in clinical trials. CONCLUSIONS: Most of the primary Andalusian treatments prescribed in the Internal Medicine services are evidence-based.