RECALMIN. La atención al paciente en las unidades de Medicina Interna del Sistema Nacional de Salud

RECALMIN. Patient care in the internal medicine units of the Spanish national health system

RECALMIN. Four years of growth of the internal medicine units of the Spanish National Health System (2013–2016)

ObjectivesTo compare the structure, resources and activity of the internal medicine units (IMUs) of the Spanish National Health System (SNHS) in 2013 and 2016. To analyse the differences between IMUs in 2016 by hospital size. Material and methodsWe conducted a comparison of 2 descriptive cross-sectional studies of IMUs in general acute care hospitals of the Spanish National Health System, with data referring to 2013 and 2016. The variables were collected via an ad hoc questionnaire (RECALMIN survey). ResultsBetween 2013 and 2016, the demand for care increased dramatically (with an annual average of 11% in hospital discharges and 16% in first consultations), and comorbidity slightly increased (2%). During this period, the mean productivity of IMUs increased 16.7% (0.6±0.3 vs. 0.7±0.3; P=.09), and the mean stay decreased 10% (9±2.2 vs. 8.1±2.1 days; P=.001). Progress in implementing good practices and systematic care for complex chronic patients was scarce. Both surveys found variability among IMUs and marked differences among IMUs of hospitals of different sizes. ConclusionsIMUs responded to the increased burden of care they supported during 2013-2016 by improving their efficiency and productivity; however, advances in implementing good practices, including care for chronic complex patients, were scare. The significant variability in the indicators of structure, activity and management models found in 2013 remained in 2016.

RECALSEEN 2024. Resources and quality in the endocrinology and nutrition units of the National Health System of Spain.

RECALMIN V. Evolution in the activity of internal medicine units of the National Health System (2007-2022).

PMH10 - Budgetary Impact Analysis of Reimbursement Varenicline in the Smoking Cessation Treatment of Patients with Major Depression in Spain

To reach a situation diagnosis on the status of patient management at digestive care units (DCUs) in Spain. A cross-sectional descriptive study across DCUs in general acute care hospitals within the Spanish National Health System (data referred to 2015). The study variables were collected with a questionnaire including items on structure, services portfolio, activity, education, research, and good practice. Hospital discharge rates for digestive diseases were also assessed using the minimum basic data set (2005-2014). Two hundred and nine hospitals invited, 55 responders (26.3%). Average discharges from hospital were 1,139 ± 653 per DCU/year, and 100 ± 66 per year per dedicated gastroenterologist. In 2014, admission rate to DCUs per 1,000 population and year was 280, with a mean stay of 7.4 days. The analysis of the MBDS for 2005-2014 reveals a progressive increase in the number of discharges (37% more in 2014 versus 2005), with a 28% decrease in hospital gross mortality rate (3.7% in 2014) and a slightly reduced (14%) mean stay (7.6 days in 2014). Considerable variability may be seen in structure, activity, and results indicators. Mortality and readmission rates, as well as mean stay, vary more than 100% amongst DCUs, and major dispersions also exist in frequentation and results amongst autonomous communities. The RECALAD 2015 survey unveiled relevant aspects related to DCUs organization, structure, and management. The notable variability encountered likely reflects relevant differences in efficiency and productivity, and thus points out there is ample room for improvement.

RECALMIN IV. Evolution in the activity of internal medicine units of the National Health System (2008–2021)

Contact DermatitisVolume 53, Issue 3 p. 181-182 Methacrylates allergy in a professional beautician Laura Perale, Corresponding Author Laura Perale Unit of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine School of Medicine, Udine, ItalyLaura Perale Unit of Internal Medicine Policlinico Universitario di Udine 33100 Udine, Italy Tel: +39 432 559816 Fax: +39 432 42097 e-mail: laura_perale@yahoo.itSearch for more papers by this authorS. De Marchi, S. De Marchi Unit of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine School of Medicine, Udine, ItalySearch for more papers by this authorE. Cecchin, E. Cecchin Unit of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine School of Medicine, Udine, ItalySearch for more papers by this authorL. A. Sechi, L. A. Sechi Unit of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine School of Medicine, Udine, ItalySearch for more papers by this author Laura Perale, Corresponding Author Laura Perale Unit of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine School of Medicine, Udine, ItalyLaura Perale Unit of Internal Medicine Policlinico Universitario di Udine 33100 Udine, Italy Tel: +39 432 559816 Fax: +39 432 42097 e-mail: laura_perale@yahoo.itSearch for more papers by this authorS. De Marchi, S. De Marchi Unit of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine School of Medicine, Udine, ItalySearch for more papers by this authorE. Cecchin, E. Cecchin Unit of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine School of Medicine, Udine, ItalySearch for more papers by this authorL. A. Sechi, L. A. Sechi Unit of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine School of Medicine, Udine, ItalySearch for more papers by this author First published: 26 August 2005 https://doi.org/10.1111/j.0105-1873.2005.0407n.xCitations: 7Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume53, Issue3September 2005Pages 181-182 RelatedInformation

BackgroundHaemophilia A (HA) has been associated with poor health-related quality of life and a large economic burden, accentuated by severity, arthropathy, and inhibitors. To meet global standards of care, the management of HA should align with the principles of care outlined by the World Federation of Haemophilia. The aims of the present study were to establish a set of proposals to improve HA management within the Spanish National Health System (SNHS) and to estimate the impact its hypothetical implementation would generate from a clinical, healthcare, economic, and social perspective.MethodsA multidisciplinary group of experts agreed on a set of 15 proposals to improve HA management within the SNHS. Thereafter, a forecast-type Social Return on Investment analysis was carried out to estimate the impact of implementing this set of proposals within the SNHS over a one-year timeframe, in relation to the required investment.ResultsThis study estimated that the implementation of the complete set of 15 proposals would require a total investment of 2.34 M€ and have a total impact of 14.60 M€. Accordingly, every euro invested in the complete set of 15 proposals would yield a social return of €6.23 (€3.37 in the worst-case scenario and €9.69 in the best-case scenario) of both tangible and intangible nature in similar proportions (45.71 and 54.29%, respectively).ConclusionsThese results can be used to inform policy and practice such that interventions that may potentially improve current public health challenges associated with the management of HA may be implemented.

RECALMIN IV. Evolución de la actividad de las unidades de medicina interna del Sistema Nacional de Salud (2008-2021)

Adapting the spanish healthcare system for disease-modifying treatments in early-stage alzheimer's disease.

The primary health care in the Spanish National Health System is organised in health centres with multi-professional teams, composed of doctors and nurses specialised in family and community health, in addition to other professionals. This article analyses the role of primary health care nurses in the Spanish National Health System. In the last decade, new concepts of task sharing between doctors and nurses as well as advanced nursing roles have been evolved in the health centres that focus on improving care for chronically ill patients and access to primary care. With shared responsibility, nurses are responsible for chronic patients in stable conditions, health prevention and promotion. The scaling up of advanced nursing tasks is limited by uncertainties of roles, disparities between states, and legislations that do not cover the full extent of advanced nursing tasks. The case study of Spain indicates that a strong multi-professional model of primary health care teams is a crucial basis for the evolvement of advanced nursing practice and its acceptance in daily routines. However, advantageous education structures and legislations are needed to allow nurses to develop their contribution in the full potential.

This work evaluates the potential impact at territorial level of the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System on hepatitis C virus (HCV)-associated hospitalizations. Chronic HCV-related hospitalization discharges from 2014 to 2018 were obtained from the National Registry of Hospitalisations. A descriptive analysis of the hospitalizations was performed for all chronic, advanced liver disease and non-advanced liver disease. Hospitalization rates were calculated at national and regional level. Year 2015 and period 2016-2018 hospitalization rates were compared to 2014 hospitalization rates using a Poisson model. Municipal standardized hospitalization rates ratios adjusted by age-group were calculated for 2016-2018 period (2014 hospitalization rates as reference). From 2014 to 2018, there were 22,352 chronic HCV-related hospitalizations. In-hospital fatality rate was 4.3% for non-advanced liver disease and 11.7% for advanced liver disease patients. National hospitalization rate decreased 22% (95% CI: 21%-22%), 16% (95% CI: 15%-17%) and 34% (95% CI: 33%-35%) in 2016-2018 compared to 2014 for all chronic, non-advanced and advanced liver disease, respectively. During 2016-2018 period, 11/19 Spanish regions achieved >20% decrease in the hospitalization rates (p<.001) for non-advanced liver disease and 19/19 (except Melilla, the rest with p<.001) for advanced liver disease. At municipal level, 84.8% and 90.2% municipalities had <20% of chronic HCV-related hospitalization need compared to 2014 adjusted by age-group. Based on the data analysed, a high impact on reducing chronic HCV-associated hospitalizations have been achieved after the implementation of the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System. However, small differences between regions and rural/urban areas were noticed.

Background: Monitoring antimicrobial use is crucial for understanding current prescribing practices. Such information helps in establishing stewardship programs for effectively using antimicrobials and combating resistance to them. Objectives: This study describes how antimicrobials are prescribed at the Veterinary Teaching Hospital of the University of Pisa and compares how the internal medicine and intensive care units differ in their usage of antimicrobials. Methods: The study involved cats that were presented in the units in 2021 and 2022. Antimicrobial prescriptions were obtained via the hospital’s management software (OCIROE). Results: In a population of 1164 non-surgical cats with 397 antimicrobials prescribed, the most prescribed ones were amoxicillin–clavulanic acid in the internal medicine unit and ampicillin in the intensive care unit. Twenty-five percent of all antimicrobials were Highest-Priority Critically Important Antimicrobials or Antimicrobial Advice Ad Hoc Expert Group Category B. The oral route was the main route of administration in the internal medicine unit, while parenteral was the most common route used in the intensive care unit. Most antimicrobials were prescribed to treat pathologic conditions affecting the urinary (39%), gastroenteric (21%), respiratory (13%), and integumentary (12%) systems. A diagnosis, accurate dosage, and the use of species-approved medications were recorded in the antimicrobial prescriptions. However, only 11% of these prescriptions were supported by antimicrobial susceptibility tests. Conclusions: These results suggest room for improvement, particularly in increasing the use of antimicrobial susceptibility testing to ensure more targeted antimicrobial therapy. Given the importance of antimicrobial resistance and the One Health approach, the study also highlights the need to consider the broader impact of antimicrobial use in animals, including the potential contribution to resistance in bacteria that affect both animal and human health.