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

Objectives: To perform a situation analysis of the care provided by internal medicine units (IMUs) in Spain and to develop, based on this analysis, proposals for improving the quality of care in these units. Material and methods: A descriptive, cross-sectional study of the IMUs of general acute care hospitals of the Spanish National Health System (SNHS), with data referring to 2013. The study variables were collected via an ad hoc questionnaire. Results: Of the total 260 hospitals identified in the SNHS, 142 responses were obtained from 139 hospitals throughout Spain, which represents 53.5% of the IMUs in the SNHS. The mean number of internists per IMU was 14 +/- 8, with a mean rate of 7.2 +/- 3.3 internists per 100,000 inhabitants. In 2013, the average number of hospital discharges from the IMU was 2,987 +/- 2,066, and those discharged by internists was 232 +/- 107. Sixty-one percent of the IMUs had implemented an interconsultation unit, and 41% had implemented a systematic care program for complex chronic patients. Thirty-three percent of the IMUs conducted multidisciplinary rounds, and 60% of these IMUs planned the discharge. Conclusions: The 2013 RECALMIN survey revealed a number of important aspects of the organisation, structure and management of IMUs. The remarkable variability in the indicators of structure, activity and management probably reflect significant differences in efficiency and productivity, which therefore provide significant room for improvement. (C) 2016 Elsevier Espana, S.L.U. y Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.