Admissions to an Internal Medicine Department: 20 Year Evolution in A Referral Hospital

Abstract

Introduction: The admissions to the Internal Medicine wards have changed over the years leading to a transformation in the type of admitted patients. The purpose of this paper is to assess the evolution of the admissions to the Internal Medicine wards of a referral hospital over 20 years.

Material and Methods: Using the Homogeneous Diagnosis Groups database, the admissions to the Internal Medicine wards of a referral hospital were evaluated for age, sex, mortality rate, length of hospital stay, type of admission (urgent or scheduled), main and secondary diagnosis. They were assessed in two 3-year periods with a 20-year hiatus (1/1/1992-31/12/1994: 10 817 episodes and 1/1/2012-31/12/2014: 17 535 episodes). In a subsequent analysis the episodes with a main diagnosis belonging to the V code category were excluded.

Results: There was an increase in the age of patients (median: 61 to 79 years-old, age over 65: 36.9% to 80.3% and over 85: 3% to 26.3%), a growing number of females (47.4% to 5.1.8%), a decrease in the length of hospital stay (16.8 to 10.3 days), a rise in the mortality rate (8.3% to 15.4%) and in the number of secondary diagnosis (episodes with more than 6 diagnosis from 17.5% to 64.8%). The increase in the prevalence of respiratory diseases (11.1% to 63.1%), infectious diseases (6.7% to 10.3%) and urinary diseases (3.9% to 11.3%) also stood out.

 Discussion: We reason that the ageing population, the reorganization of hospital departments and the pressure of the emergency department over the wards is stirring a change causing functional limitations and restrictions to medical education.