RESUMEN
BACKGROUND: By high resolution consultation (HRC) we mean an ambulatory process of assistance fulfilled in a single day, by which treatment and diagnosis are established and recorded. OBJECTIVE: To assess to which extent patients with digestive conditions may benefit from a single consultation system. MATERIAL: A descriptive study of 179 first visit events, randomly selected as high-resolution consultations in gastroenterology. We discuss the percentage of patients who benefited from HRC and the complementary tests performed. RESULTS: Most common conditions included dyspepsia (16%), a family history of colon cancer (16%) and gastroesophageal reflux disease (GERD) (16%). Seventy-nine (44%) of all first visits became HRCs and 80 (45%) required a diagnostic test (100% abdominal ultrasound) that was reviewed on the same day. Performing a test on the same day significantly increased the percentage of HRCs (57% vs. 34%, p < 0.002). GERD, dyspepsia, cholelithiasis and chronic liver disease were the subjects most commonly leading to HRC. CONCLUSIONS: Gastroenterology consultations may largely benefit from an HRC system with only organizational changes and no additional costs.
Asunto(s)
Gastroenterología/métodos , Derivación y Consulta , Adulto , Anciano , Enfermedades del Sistema Digestivo/diagnóstico , Femenino , Enfermedades Gastrointestinales/diagnóstico , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Consulta Remota/métodos , EspañaRESUMEN
Antecedentes: la consulta alta resolución o única es aquel proceso asistencial ambulatorio en el que queda establecido un diagnóstico junto con su correspondiente tratamiento y reflejados ambos en un informe clínico, siendo realizadas estas actividades en una sola jornada. Objetivos: conocer en qué grado los pacientes con patología digestiva pueden beneficiarse del sistema de consultas en acto único. Material: estudio descriptivo de 179 episodios de primeras vistas seleccionadas aleatoriamente de una consulta de alta resolución de gastroenterología. Analizamos el porcentaje de pacientes que se beneficiaron de una consulta en acto único así como de las pruebas complementarias realizadas. Resultados: las patologías más frecuentes atendidas fueron la dispepsia (16%), los antecedentes familiares de cáncer de colon (16%) y enfermedad por reflujo gastroesofágico (16%). Setenta y nueve (44%) de las primeras visitas se resolvieron en consulta única y 80 (45%) de una prueba diagnóstica (100% ecografía abdominal) y revisión tras esta en el mismo día. La realización de una prueba en el día incrementaba significativamente el porcentaje de consulta única frente a los que no se les realizaba (57% frente a 34%, p < 0,002). Los pacientes con enfermedad por reflujo gastroesofágico, dispepsia, colelitiasis y hepatopatía crónica eran las patologías que terminaban en mayor porcentaje en consulta única. Conclusiones: las consultas de gastroenterología pueden beneficiarse en gran medida de un sistema de consulta de alta resolución solo con cambios organizativos y sin costes adicionales especiales (AU)
Background: By high resolution consultation (HRC) we mean an ambulatory process of assistance fulfilled in a single day, by which treatment and diagnosis are established and recorded. Objective: To assess to which extent patients with digestive conditions may benefit from a single consultation system. Material: A descriptive study of 179 first visit events, randomly selected as high-resolution consultations in gastroenterology. We discuss the percentage of patients who benefited from HRC and the complementary tests performed. Results: Most common conditions included dyspepsia (16%), a family history of colon cancer (16%) and gastroesophageal reflux disease (GERD) (16%). Seventy-nine (44%) of all first visits became HRCs and 80 (45%) required a diagnostic test (100% abdominal ultrasound) that was reviewed on the same day. Performing a test on the same day significantly increased the percentage of HRCs (57% vs. 34%, p < 0.002). GERD, dyspepsia, cholelithiasis and chronic liver disease were the subjects most commonly leading to HRC. Conclusions: Gastroenterology consultations may largely benefit from an HRC system with only organizational changes and no additional costs (AU)