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

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.