Abstract
Over the past few decades the rising burden of chronic disorders and multimorbidity has heavily challenged health systems worldwide. In general terms, the architecture of a healthcare service should be dictated by the needs of the population it serves [ [1] Jenkins P.F. Medical generalists and specialists: time for proportional representation?. Future Hosp. J. 2016; 3: 8-9 Google Scholar ]. Chronic, multimorbid disorders would benefit from a broader and “holistic” approach and management but are individual diseases that nowadays impact health-care resources, medical research, and even medical education, where students are less and less attracted by generalist disciplines [ [2] Cassel C.K. Reuben D.B. Specialization, subspecialization, and subsubspecialization in internal medicine. N Engl J Med. 2011; 364: 1169-1173 Google Scholar ]. The individual, economic and societal price resulting from the collision between the relentless epidemiological switch toward chronicity and multimorbidity and the actual specialty and subspecialty-driven architecture of health-care systems is high [ [3] Barnett K. Mercer S.W. Norbury M. Watt G. Wyke S. Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012; 380: 37-43 Google Scholar ]. Generalist vs specialist acute medical admissions - What is the impact of moving towards acute medical subspecialty admissions on efficacy of care provision?European Journal of Internal MedicineVol. 98PreviewIn an era of increasing hospital admissions and a growing older population with multiple co-morbidities [1], the discussion surrounding generalist versus specialist medical acute admissions continues to stimulate debate. Annually, the demand and volume of hospital admissions are increasing with more patients being treated on trolleys [1]. There remains an onus on hospital clinicians to manage existing resources efficiently. Full-Text PDF
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