Consultation patterns and clinical correlates of consultation in a tertiary care setting

<p>Abstract</p> <p>Background</p> <p>Consultation 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...

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Main Authors: Conley Joslyn, Jordan Michaela R, Ghali William A
Format: Article
Language:English
Published: BMC 2008-10-01
Series:BMC Research Notes
Online Access:http://www.biomedcentral.com/1756-0500/1/96
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author Conley Joslyn
Jordan Michaela R
Ghali William A
author_facet Conley Joslyn
Jordan Michaela R
Ghali William A
author_sort Conley Joslyn
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Consultation 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.</p> <p>Methods and findings</p> <p>Hospital 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.</p> <p>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%).</p> <p>Conclusion</p> <p>Consultation 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.</p>
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spelling doaj.art-c10de1f4458a42249998cd3e918fc0b82022-12-22T00:11:02ZengBMCBMC Research Notes1756-05002008-10-01119610.1186/1756-0500-1-96Consultation patterns and clinical correlates of consultation in a tertiary care settingConley JoslynJordan Michaela RGhali William A<p>Abstract</p> <p>Background</p> <p>Consultation 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.</p> <p>Methods and findings</p> <p>Hospital 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.</p> <p>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%).</p> <p>Conclusion</p> <p>Consultation 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.</p>http://www.biomedcentral.com/1756-0500/1/96
spellingShingle Conley Joslyn
Jordan Michaela R
Ghali William A
Consultation patterns and clinical correlates of consultation in a tertiary care setting
BMC Research Notes
title Consultation patterns and clinical correlates of consultation in a tertiary care setting
title_full Consultation patterns and clinical correlates of consultation in a tertiary care setting
title_fullStr Consultation patterns and clinical correlates of consultation in a tertiary care setting
title_full_unstemmed Consultation patterns and clinical correlates of consultation in a tertiary care setting
title_short Consultation patterns and clinical correlates of consultation in a tertiary care setting
title_sort consultation patterns and clinical correlates of consultation in a tertiary care setting
url http://www.biomedcentral.com/1756-0500/1/96
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