• Acta Otorrinolaringol Esp · Sep 2015

    Observational Study

    Effect of comanagement with internal medicine on hospital stay of patients admitted to the Service of Otolaryngology.

    • Eduardo Montero Ruiz, Ángela Rebollar Merino, Teresa Rivera Rodríguez, Marta García Sánchez, Rosa Agudo Alonso, and José Maria Barbero Allende.
    • Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España. Electronic address: eduardo.montero@salud.madrid.org.
    • Acta Otorrinolaringol Esp. 2015 Sep 1; 66 (5): 264-8.

    Introduction And ObjectivesPatients admitted to the Department of Otolaryngology (ENT) are increasing in age, comorbidity and complexity, leading to increased consultations/referrals to Internal Medicine (IM). An alternative to consultations/referrals is co-management. We studied the effect of co-management on length of stay (LoS) in hospital for patients admitted to ENT.MethodsThis was a retrospective observational study including patients ≥14 years old discharged from ENT between 1/1/2009 and 30/06/2013, with co-management from May/2011. We analysed age, sex, type of admission, whether the patient was operated, administrative weight associated with DRG, total number of discharge diagnoses, Charlson comorbidity index (CCI), deaths, readmissions and LoS.ResultsThere were statistically significant differences between both groups in age (4.5 years; 95% confidence interval [95% CI] 2.8-6.3), emergency admissions (odds ratio [OR] 1.4; 95% CI 1.1-1.8), administrative weight (0.3637; 95% CI 0.0710-0.6564), number of diagnoses (1.3; 95% CI 1-1.6), CCI (0.4; 95% CI 0.2-0.6) and deaths (OR 4.1; 95% CI 1.1-15.7). On adjustment, co-management reduced ENT LoS in hospital by 28.6%, 0.8 days (95% CI 0.1-1.6%; P=.038). This reduction represents an ENT savings of at least €165,893.ConclusionsCo-management patients admitted to ENT are increasing in age, comorbidity and complexity. Co-management is associated with reduced LoS and costs in ENT, similar to those observed in other surgical services.Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

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