PICTURE-IM: Portuguese Initiative for Characterizing Hospitalization: A Multicentre Retrospective Report of Internal Medicine – PART 1
DOI:
https://doi.org/10.24950/rspmi.2848Keywords:
Hospitalization, Internal Medicine, Multimorbidity, PortugalAbstract
Introduction:
Internal Medicine (IM) plays a pivotal role in the management of adults with complex medical conditions, both in hospital and outpatient settings. Its scope encompasses the diagnosis and treatment of acute illnesses as well as the long-term management of chronic diseases. Despite numerous studies conducted on IM departments, few studies have comprehensively characterized the hospitalized population in IM wards in Portugal. This study aims to highlight the importance of IM within the Portuguese healthcare system and to describe the complexity of the patients and conditions managed by internists. Part 1 of this study presents the general characteristics of the hospitalized population.
Methods:
We conducted a multicentric, observational, cross-sectional study involving 25 of the 45 IM departments within the Portuguese Health System, coordinated by the Young Internists Group of the Portuguese Society of Internal Medicine. Data were collected on patient demographics, comorbidities, hospitalization characteristics, and outcomes.
Results:
A total of 7282 hospitalizations were analysed. The mean patient age was 77 years, and most were women (50.95%). Nearly half of the patients (48.47%) were independent or slightly dependent in daily living activities, while 18.32% were highly dependent. Multimorbidity and cardiovascular risk factors were highly prevalent: 80.34% of patients had multimorbidity, 72.38% hypertension, 52.78% dyslipidemia, and 35.09% diabetes. The majority (52.76%) were discharged home, 13.73% to nursing homes, and 9.76% to the National Network for Integrated Continuous Care. The mean length of stay (LOS) was 23 days, though 15.49% of hospitalizations were prolonged due to social reasons; excluding these, the mean LOS was 15 days. The in-hospital mortality rate was 15.52%. Primary diagnoses most frequently corresponded to ICD-10 groups X (32.18%), IX (23.42%), XIV (10.08%), I (6.41%), and XI (4.41%).
Conclusion:
This study underscores the diverse and complex nature of hospitalizations managed by IM departments and highlights their essential contribution to the Portuguese healthcare system. Strengthening support for IM is crucial to meet the evolving needs of an aging and multimorbid population, ensuring high-quality, patient-centred, and sustainable care.
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