Highlights
- •Full economic evaluation studies of quick diagnosis units (QDUs) are lacking.
- •There were notable cost savings from hospitalization in anemia and cancer patients.
- •Main health outcomes of QDU and hospitalization by cost-minimization were equivalent.
- •Highest QDU savings corresponded to fixed costs of hospital stays (66% of savings).
- •QDU savings from structural/general functioning costs of hospitalization were 33%.
Abstract
Background
Aims
Methods
Results
Conclusion
Keywords
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Internal MedicineReferences
- Will austerity cuts dismantle the Spanish healthcare system?.BMJ. 2013; 346: f2363
- The painful effects of the financial crisis on Spanish health care.Int J Health Serv. 2014; 44: 25-51
- Reforming Spanish health care: a matter of survival.Health Policy. 2015; 119: 107-110
- Should alternatives to conventional hospitalisation be promoted in an era of financial constraint?.Eur J Clin Invest. 2013; 43: 602-615
- Health at a glance: Europe 2012.OECD Publishing, 2012 (http://dx.doi.org/10.1787/9789264183896-en (accessed July 5, 2015))
- Explaining high health care spending in the United States: an international comparison of supply, utilization, prices, and quality.Issue Brief (Commonw Fund). 2012; 10: 1-14
- Direct medical costs of COPD—an excess cost approach based on two population-based studies.Respir Med. 2012; 106: 540-548
- Health policy in the financial crisis. European observatory on health systems and policies.Eurohealth. 2012; 18 (http://www.euro.who.int/__data/assets/pdf_file/0005/162959/Eurohealth_Vol-18_No-1_web.pdf?ua=1 (accessed July 5, 2015)): 3-6
- Coping with austerity in the Irish health system. European observatory on health systems and policies.Eurohealth. 2012; 18 (http://www.euro.who.int/__data/assets/pdf_file/0005/162959/Eurohealth_Vol-18_No-1_web.pdf?ua=1 (accessed July 5, 2015)): 7-9
- Austerity: a failed experiment on the people of Europe.Clin Med. 2012; 12: 346-350
- Respiratory day hospital: a novel approach to acute respiratory care.CMAJ. 2001; 165: 1067-1071
- Intravenous diuretic day-care treatment for patients with heart failure.Clin Med. 2012; 12: 133-136
- Defining and disseminating the hospital-at-home model.CMAJ. Jan 20 2009; 180: 156-157
- Admission avoidance hospital at home.Cochrane Database Syst Rev. 2008; 4CD007491
- Early discharge hospital at home.Cochrane Database Syst Rev. 2009; 1CD000356
- Quick diagnosis units: a potentially useful alternative to conventional hospitalisation.Med J Aust. 2009; 191: 496-498
- Quick diagnosis units: avoiding referrals from primary care to the ED and hospitalizations.Am J Emerg Med. 2013; 31: 114-123
- Quick diagnosis units—an effective alternative to hospitalization for diagnostic workup: a systematic review.J Hosp Med. 2014; 9: 54-59
- State of emergency medicine in Spain.Int J Emerg Med. 2010; 3: 219-226
- Diagnosing unexplained fever: can quick diagnosis units replace inpatient hospitalization?.Eur J Clin Invest. 2014; 44: 707-718
- Evaluation of unexplained peripheral lymphadenopathy and suspected malignancy using a distinct quick diagnostic delivery model: prospective study of 372 patients.Medicine (Baltimore). 2014; 93e95
- Reduction in inappropriate hospital use based on analysis of the causes.BMC Health Serv Res. 2012; 12: 361
- [Appropriateness of the admissions and stays in an internal medicine department of a secondary hospital using the current version of the AEP (Appropriateness Evaluation Protocol)].An Med Interna. 2003; 20: 297-300
- Inappropriate admissions: thoughts of patients and referring doctors.J R Soc Med. 2001; 94: 628-631
- Quick diagnosis units versus hospitalization for the diagnosis of potentially severe diseases in Spain.J Hosp Med. 2012; 7: 41-47
- [Quick and early diagnostic outpatient unit: an effective and efficient assistential model. Five years experience].Med Clin (Barc). 2004; 123: 247-250
- Rapid diagnosis unit in a third level hospital. Descriptive study of the first year and a half.Rev Clin Esp. 2008; 208: 561-563
- [Rapid diagnosis units or immediate health care clinics in internal medicine. Analysis of the first six months of operation in Palencia (Spain)].Semergen. 2012; 38: 126-130
- Comparison of quick diagnosis units and conventional hospitalization for the diagnosis of cancer in Spain: a descriptive cohort study.Oncology. 2012; 83: 283-291
- Quick diagnosis units or conventional hospitalisation for the diagnostic evaluation of severe anaemia: a paradigm shift in public health systems?.Eur J Intern Med. 2012; 23: 159-164
- Cancer diagnosis and outcomes in Michigan EDs vs other settings.Am J Emerg Med. 2012; 30: 283-292
- QED: quick and early diagnosis.Lancet. 1996; 348: 528-529
- A quick diagnosis unit as an alternative to conventional hospitalization in a tertiary public hospital: a descriptive study.Pol Arch Med Wewn. 2013; 123: 582-588
Conjunto Mínimo Básico de Datos (CMBD). Norma Estatal. Registro de Altas de los Hospitales Generales del Sistema Nacional de Salud. Ministerio de Sanidad, Servicios Sociales e Igualdad http://www.msssi.gob.es/estadEstudios/estadisticas/cmbd.htm (accessed July 5, 2015).
Clasificación Internacional de Enfermedades, 9ª Revisión, Modificación Clínica (CIE-9-MC). Ministerio de Sanidad, Servicios Sociales e Igualdad http://eciemaps.mspsi.es/ecieMaps/browser/index_9_mc.html (accessed July 5, 2015).
- Hospital costs estimation and prediction as a function of patient and admission characteristics.Int J Health Plann Manage. 2008; 23: 345-355
- What hospital inpatient services contributed the most to the 2001–2006 growth in the cost per case?.Health Serv Res. 2012; 47: 1814-1835
- The growing role of emergency departments in hospital admissions.N Engl J Med. 2012; 367: 391-393
- The burden of chronic disorders on hospital admissions prompts the need for new modalities of care: a cross-sectional analysis in a tertiary hospital.QJM. 2009; 102: 193-202
- What is health economics?.2nd ed. Hayward Medical Communications, London2009
Drummond MF, Sculpher MJ, Torrance GW, OBrien BJ, Stoddart GL, eds. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press, 2005. 3rd ed.
- What is cost-minimization analysis?.in: RJG A. Pharmacoeconomics. From theory to practice. CRC Press, Boca Raton (Fl)2010: 83-94
- Primary care referrals of patients with potentially serious diseases to the emergency department or a quick diagnosis unit: a cross-sectional retrospective study.BMC Fam Pract. 2014; 15: 75
- The indirect costs of graduate medical education.N Engl J Med. 1985; 312: 1233-1238
- Does experience matter? A comparison of the practice of attendings and residents.J Gen Intern Med. 2005; 20: 497-503
- A review of cost-effectiveness, cost-containment and economics curricula in graduate medical education.J Eval Clin Pract. 2010; 16: 1055-1062