Evaluation of the diagnostic efficacy of patients with dyspepsia in the consulting between internists and general practitioners

• Published in: Medicina clínica Vol. 123; no. 10; p. 374
• Format: Journal Article
• Language: Spanish
• Published: Spain 25-09-2004
• Subjects: Adolescent; Adult; Aged; Case-Control Studies; Dyspepsia - diagnosis; Evaluation Studies as Topic; Female; Humans; Male; Middle Aged; Peptic Ulcer - diagnosis; Physicians, Family; Prospective Studies; Referral and Consultation - statistics & numerical data
• ISSN: 0025-7753

Our goal was to evaluate the efficacy of internal medicine consulting (CIM) in primary care (PC) for the care of patients with dyspepsia.
Prospective case-control study of a population of 87,016 inhabitants during a 2 years period. We included patients with dyspepsia (319) jointly attended by a family physician (FP) and consulting internists (CI). The CI went weekly to the primary care center (PCC) to attend patients who would have been referred to the hospital outpatient clinic for specialized care (SC). As control group, 775 patients with dyspepsia were randomly and simultaneously chosen among a total of 29,317 first medical referrals during the period of the study.
5.36% of the consultations for SC were patients with dyspepsia (annual incidence of 183 patients/1,000 inhabitants). We observed a significant reduction in: mean time for SC (26.4 days; 22.4-30.4), mean number of tests per patient ordered by SC (0.77; 0.42-1.12), mean time for patient information on the tests ordered by SC (27.3 days; 18.7-35,9), mean time for the resolution of the process (27.3 days; 18.4-36.2) and rate of specialized follow-up visits (25.2%; 18.5-31.9); p < 0.005 in all cases. The resolution rate of the process (37.2%; 25.7-48.7) and the discharge rate (38.7%; 28.9-48.5) were significantly higher for CIM (p < 0.01 in both cases). The referral rate for SC showed a negative correlation (r = -0.97; p < 0.01) with the quality of the management; this rate related to the type of training, age and years of medical practice of the GPs. Satisfaction of patients with the CIM was very high.
The CIM with PC improves the efficacy of the specialized medical care of patients with dyspepsia.