Unidad de diagnóstico rápido: un modelo asistencial eficaz y eficiente. Experiencia de 5 años

Capell, Santiago; Comas, P.; Piella, Teresa; Rigau, Joaquim; Pruna, Xavier; Martínez, Francesc; Montull, Santiago

doi:10.1157/13065197

Cited by 11 publications

(8 citation statements)

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“…Although a common diagnosis in Spanish QDUs (nearly 20% of patients) [6,7,8], no study has evaluated the utility of QDUs in cancer patients, even though the Strategy on Cancer of the Spanish National Health System 2010 states ‘[every] patient with a well-founded clinical suspicion of cancer must undergo a first confirmatory diagnostic test within 15 days’ [26] and that ‘[any] patient with a proven diagnosis of cancer must have an appointment in their hospital within a week of confirmation to propose a specific therapeutic plan’.…”

Section: Discussionmentioning

confidence: 99%

“…In publicly funded healthcare systems, such as in Spain, where 90% of hospitals are public, PHC referrals for diagnostic procedures are subject to long waiting times, and physicians and patients often resort to using the emergency department (ED) to circumvent these problems [6,7]. …”

Section: Introductionmentioning

confidence: 99%

“…Due to shortcomings in outpatient services in Spain and other countries, acute beds are increasingly occupied by patients requiring diagnostic tests for non-acute but potentially severe diseases not requiring urgent treatment, thus reducing acute beds [6,8]. Although studies suggest that in Spain, as many as 20% of hospitalized patients in internal medicine departments could be studied on an outpatient basis, delays in outpatient diagnostic tests often render them impractical, especially when rapid tests for suspected cancer are required [9,10,11].…”

Section: Introductionmentioning

confidence: 99%

“…The search for alternatives includes quick diagnosis units (QDUs), i.e. outpatient diagnostic units for patients with suspected severe disease, mainly cancer [6,8,12]. …”

Section: Introductionmentioning

confidence: 99%

“…Most Spanish tertiary public hospitals and 30% or more of district hospitals now have QDUs, which are generally led by general internists and provide a prompt, effective diagnosis for patients with suspected severe disease, especially cancer [6,7,8]. …”

Section: Introductionmentioning

confidence: 99%

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Comparison of Quick Diagnosis Units and Conventional Hospitalization for the Diagnosis of Cancer in Spain: A Descriptive Cohort Study

Bosch

Moreno²,

Ríos³

et al. 2012

Oncology

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Objective: Quick diagnosis units (QDUs) in Spain provide patients with severe disease who would normally require hospitalization with the prompt and effective diagnosis they deserve. We compared the value and cost of a QDU and of conventional hospitalization in assessing patients with cancer. Methods: In a descriptive cohort study, 169 patients with a final diagnosis of cancer were prospectively evaluated between November 2008 and April 2010. We also analyzed a retrospective cohort of 53 randomly selected patients with neoplasia hospitalized during this period. In addition to the variables time to diagnosis and length of stay, we compared the costs of both models using microcosting techniques. Results: Colorectal cancer was the commonest cancer (26%). QDU patients were younger than hospitalized patients (68.3 vs. 74.7 years; p < 0.05), and there were also significant differences with respect to the source of referral (p < 0.00001) and destination (p < 0.00001), but not regarding diagnosis (p > 0.34), reason for consultation (p > 0.26) and time to diagnosis/length of stay (Wilcoxon rank sum test, p > 0.05). The mean costs for hospitalization were EUR 4,059.37 compared with EUR 601.84 in the QDU. Conclusion: For diagnostic purposes, cancer patients can be managed similarly in a QDU or in in-hospital settings, but the QDU model seems to incur fewer costs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The search for alternatives includes quick diagnosis units (QDUs), i.e. outpatient diagnostic units for patients with suspected severe disease, mainly cancer [6,8,12]. …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of Quick Diagnosis Units and Conventional Hospitalization for the Diagnosis of Cancer in Spain: A Descriptive Cohort Study

Bosch

Moreno²,

Ríos³

et al. 2012

Oncology

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Quick diagnosis units versus hospitalization for the diagnosis of potentially severe diseases in Spain

Bosch

Jordan

Coca

et al. 2011

Journal of Hospital Medicine

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OBJECTIVES: We describe the functioning of a quick diagnosis unit (QDU) in a Spanish public university hospital to ascertain the utility and cost of the model compared to conventional hospitalization. DESIGN: Observational study with a prospective and retrospective cohort. SETTING: Spanish tertiary public university hospital. PATIENTS: Two thousand consecutive patients evaluated between December 2007 and July 2010 with potentially severe diseases normally requiring hospitalization for diagnosis. For comparative purposes, we analyzed a randomized, retrospective cohort of 1454 hospitalized patients. MEASUREMENTS: Variables measured included source of referral, reason for consultation, time to diagnosis and length‐of‐stay, hospitalizations avoided, Charlson comorbidity index, costs, and patient satisfaction using a telephone survey. RESULTS: Suspected anemia, cachexia‐anorexia syndrome, febrile syndrome, adenopathies and/or palpable masses, abdominal pain, diarrhea, and lung abnormalities accounted for 88% of QDU patients. The most‐frequent diagnoses were cancer (26.3%) and iron‐deficiency anemia. QDU patients with anemia were significantly younger than hospitalized patients with the same diagnosis (P < 0.0001). Other parameters were similar between QDU and hospitalized patients. The mean cost of treatment was 3153.87 Euros for hospitalization and 702.33 Euros for the QDU. Patients expressed a high degree of satisfaction with QDU care. CONCLUSIONS: QDUs can manage the diagnosis of patients with potentially severe diseases equally as well as traditional hospitalization, and saves costs. QDU patients expressed a high degree of satisfaction, with most preferring this model to hospitalization. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine

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Quick diagnosis units: avoiding referrals from primary care to the ED and hospitalizations

Bosch

Jordan

López‐Soto

2013

The American Journal of Emergency Medicine

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Unidad de diagnóstico rápido: un modelo asistencial eficaz y eficiente. Experiencia de 5 años

Cited by 11 publications

References 0 publications

Comparison of Quick Diagnosis Units and Conventional Hospitalization for the Diagnosis of Cancer in Spain: A Descriptive Cohort Study

Comparison of Quick Diagnosis Units and Conventional Hospitalization for the Diagnosis of Cancer in Spain: A Descriptive Cohort Study

Quick diagnosis units versus hospitalization for the diagnosis of potentially severe diseases in Spain

Quick diagnosis units: avoiding referrals from primary care to the ED and hospitalizations

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