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      The Value of a Rapid Access Internal Medicine Clinic – An Observational Perspective

      , ,
      Canadian Journal of General Internal Medicine
      Dougmar Publishing Group, Inc.

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          Abstract

          Background: Rapid access Internal Medicine (IM) clinics aim to reduce burden on inpatient services.  Despite an increased prevalence of these clinics across Canada, there is a lack of evidence demonstrating their value.Methods: An observational retrospective review was undertaken to identify the usage of our IM clinic.  A prospective analysis of Internal Medicine Clinical Teaching Unit (CTU) diverted admissions and a subsequent cost benefit analysis was performed.Results:  Referrals were primarily from emergency room physicians (47%) and general practitioners (34%). Of the requests for admission over a 4 week period, 6.1% were diverted with clinic follow-up within four days.  Over $30,000 of inpatient care costs were prevented over the study period.Conclusion: Rapid access IM clinics help reduce demand on emergency departments and inpatient services.  A significant percentage of hospital admissions may be avoided by implementing rapid access clinics.  Further study is needed to better quantify the overall benefit.

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          The current and future financial burden of hospital admissions for heart failure in Canada: a cost analysis

          Background: Heart failure is a costly health condition and a major public health concern. We sought to examine the costs of hospital admissions for heart failure between fiscal years 2004 and 2013 in Canada and to model the future costs to 2030. Methods: Canadian Institutes for Health Information Discharge Abstract Database was used to identify admissions to hospital with heart failure as the primary diagnosis between fiscal years 2004 and 2013. Multiple linear regression models were used to calculate the trend in prevalence and extrapolate these to 2030. Canadian Institutes for Health Information patient cost estimates were used to identify costs of hospital admissions for heart failure. Generalized linear models were used to estimate average annual costs per heart failure patient. We conducted a sensitivity analysis including all admissions for heart failure in any diagnostic field. Results: In 2013, 45 600 (95% confidence interval [CI]: 43 800-47 200) patients were admitted with heart failure as the primary diagnosis, accounting for $482 (95% CI $464-$500) million. By 2030, we estimate 54 000 (95% CI 49 000-60 000) patients and costs of $722 (95% CI $650-$801) million, with older adults (age ≥ 80 yr) accounting for 52% of costs. Including admissions for which heart failure was a secondary diagnosis increases the total cost to $2.8 (95% CI $2.6-$3.0) billion in 2030. Interpretation: As in other developed countries, hospital costs related to heart failure in Canada are on the rise. Older adults are the main consumers of such hospital services. Strategies to improve outpatient care to reduce rates of admission for heart failure are needed.
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            Association of a Dedicated Post–Hospital Discharge Follow-up Visit and 30-Day Readmission Risk in a Medicare Advantage Population

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              CAN A RAPID ACCESS NEUROLOGY CLINIC REDUCE A&E ADMISSIONS?

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                Author and article information

                Journal
                Canadian Journal of General Internal Medicine
                Can Journ Gen Int Med
                Dougmar Publishing Group, Inc.
                2369-1778
                1911-1606
                August 27 2018
                August 27 2018
                : 13
                : 3
                : 15-20
                Article
                10.22374/cjgim.v13i3.244
                0bd61504-3376-4f3f-accc-9b0bdbacaa20
                © 2018

                Copyright of articles published in all DPG titles is retained by the author. The author grants DPG the rights to publish the article and identify itself as the original publisher. The author grants DPG exclusive commercial rights to the article. The author grants any non-commercial third party the rights to use the article freely provided original author(s) and citation details are cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0/


                General medicine,Geriatric medicine,Neurology,Internal medicine
                General medicine, Geriatric medicine, Neurology, Internal medicine

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