Assessment of the in-hospital course after discharge from an internal medicine service
Keywords:
Post-discharge assessment, readmissionsAbstract
Introduction and methods – Post-discharge follow-up and use of institution resources may be important
indicators in the evaluation of a Services’ activity. The authors have retrospectively analyzed some post-discharge assessment parameters in an Internal Medicine Service.
Material and Methods – Admissions to the Medicina II Service of the Coimbra University Hospital, who
were discharged, as registered on the DRG data-base, , during a 3 month period were selected. The
patients’ course inside the institution in the following 6 months was studied. Demographic data,
outpatient visits, emergency visits and readmissions were analyzed, as were mortality, principal
diagnosis, DRG and its relative weight.
Results – 72.9% of all patients had at least one post-discharge contact (outpatient visit, emergency visit,
readmission). There were 232 outpatient visits (54.2% of patients), 100 emergency visits (41.6%) and 86
readmissions (41%); of the latter, the most frequent principal diagnosis was pneumonia (10,4%). The
mortality rate was 10.4% (15 patients). Some factors influenced the results, like a relative weight over
1.0 and age under 80, which influenced the number of patients with outpatient visits, as well as the
diagnosis of pneumonia, which influenced the number of patients with emergency visits and mortality.
Conclusions – This study shows a significant impact of the post-discharge care in the same institution, in
its diverse sectors. The in-hospital mortality was probably the most important result, revealing the
general prognosis of our inpatients. The systematic review of post-discharge assessment parameters,
including in-hospital mortality and readmissions is important to overcome the difficulties in today’s
Internal Medicine Services. It is necessary, in these studies, to use comparable methods, like DRGs and
case-mix.
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