Main Article Content
Ambulatory, Clinic, Internal Medicine, Rapid Access
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.
Top 5 reasons for hospital admissions. Ottawa: Canada Institute for Health Information; 2017. Available here: https://www.cihi.ca/en/top-5-reasons-for-inpatient-hospitalizations. Accessed: June 5, 2017
Levy R. Improving Outcomes by Redirecting Care to Rapid Access Internal Medicine Clinics. March 2017 [Internet]. Available here: https://www.slideshare.net/bcpsqc/improving-outcomes-by-redirecting-care-to-rapid-access-internal-medicine-clinics. Accessed: August 18, 2017
Peukert T, McDonell G, Craig J. Can A Rapid Access Neurology Clinic Reduce A&E Admissions? J Neurol Neurosurg Psychiatry 2014; 84: e4.
Yuyun MF, Loke I, Nicholson WB, Clayton L, Squire IB. Secondary Care Rapid Access Heart Failure Clinics for Reduction in Hospitalisation. J Cardiol Clin Res 2016. 4(3): 1062-68
Guthrie B, Davies H, Greig G, et al. Delivering health care through managed clinical networks (MCNs): lessons from the North. Report for the National Institute for Health Research Service Delivery and Organisation Programme, 2010. National Institute for Health Research website. Available here: http://www.netscc.ac.uk/hsdr/files/project/SDO_FR_08-1518-103_V01.pdf. Accessed: August 18, 2017
Shen E, Koyama SY, Huynh DN, et al. Association of a Dedicated Post-Hospital Discharge Follow-Up Visit and 30-Day Readmission Risk in a Medicare Advantage Population. JAMA Internal Medicine 2017. 117(1): 132-135