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The impact of co-working with an Internist in a high-speciality division of cardiology in a third-level centre. Experience with a new organization model

  • Author Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Valentina Scheggi
    Correspondence
    Corresponding author.
    Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Affiliations
    Division of Cardiovascular and Perioperative Medicine, Cardiothoracovascular Department, Careggi University Hospital, Largo Brambilla 3, Florence 50134, Italy
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  • Author Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Lorenzo Righi
    Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Affiliations
    Health Direction, Italy
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  • Author Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Guia Moschi
    Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Affiliations
    Division of General Cardiology, Italy
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  • Author Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Maria Teresa Mechi
    Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Affiliations
    Health Direction, Italy
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  • Author Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Niccolò Marchionni
    Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
    Affiliations
    Division of General Cardiology, Italy
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  • Author Footnotes
    1 Azienda Ospedaliero-Universitaria Careggi and University of Florence, Italy. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation
      Despite remarkable international differences, most European health care systems rely on a primary care, a secondary care and more specialized or tertiary institutions, which often focus mainly on one organ or system. Nonetheless, the continuous increase of chronic comorbidities that is secondary to ageing of the general population, imposes a global treatment approach, which goes far beyond the highly specialized management of a single acute, or acutely decompensated, index condition. In this evolving epidemiologic scenario, a general Internist working in academic, highly specialized settings, may valuably contribute to improve the effectiveness and cost-effectiveness of a focused, single specialty approach [
      • Tanriover M.D.
      • Rigby S.
      • van Hulsteijn L.H.
      • Ferreira F.
      • Oliveira N.
      • Schumm-Draeger P.M.
      • Weidanz F.
      • Kramer M.H.
      Working group on professional issues, European federation of internal medicine (EFIM). What is the role of general internists in the tertiary or academic setting?.
      ]. Indeed, since such a specialized approach is deemed unable to address comprehensive care [
      • Hendriks J.M.
      • Jaarsma T.
      The multidisciplinary team approach in cardiovascular care.
      ], many practice guidelines highlight that a multidisciplinary team can improve patient outcomes in several specialized contexts [
      • Barnett K.
      • Mercer S.W.
      • Norbury M.
      • Watt G.
      • Wyke S.
      • Guthrie B.
      Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study.
      ,
      • Cooper L.B.
      • Hernandez A.F.
      Assessing the quality and comparative effectiveness of team-based care for heart failure: who, what, where, when, and how.
      ].

      Keywords

      Abbreviations:

      DRG (diagnosis related groups)
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      References

        • Tanriover M.D.
        • Rigby S.
        • van Hulsteijn L.H.
        • Ferreira F.
        • Oliveira N.
        • Schumm-Draeger P.M.
        • Weidanz F.
        • Kramer M.H.
        Working group on professional issues, European federation of internal medicine (EFIM). What is the role of general internists in the tertiary or academic setting?.
        Eur J Intern Med. 2015; 26 (Jan): 9-11
        • Hendriks J.M.
        • Jaarsma T.
        The multidisciplinary team approach in cardiovascular care.
        Eur J Cardiovasc Nurs. 2021; 20 (Apr 13): 91-92
        • Barnett K.
        • Mercer S.W.
        • Norbury M.
        • Watt G.
        • Wyke S.
        • Guthrie B.
        Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study.
        Lancet. 2012; 380 (Jul 7): 37-43
        • Cooper L.B.
        • Hernandez A.F.
        Assessing the quality and comparative effectiveness of team-based care for heart failure: who, what, where, when, and how.
        Heart Fail Clin. 2015; 11 (Jul): 499-506
        • Kramer M.H.
        • Akalin E.
        • Melchor A.M.S.
        • Bitterman H.
        • Ferreira F.
        • Higgens C.
        • Schumm-Draeger P.M.
        • Köberling J.
        • Tanriover M.D.
        • Bauer W.
        • Working Group on Professional Issues in Internal Medicine
        Internal medicine in Europe: how to cope with the future? An official EFIM strategy document.
        Eur J Intern Med. 2010; 21 (Jun): 173-175
        • Kramer M.H.
        • Bauer W.
        • Dicker D.
        • Durusu-Tanriover M.
        • Ferreira F.
        • Rigby S.P.
        • Roux X.
        • Schumm-Draeger P.M.
        • Weidanz F.
        • van Hulsteijn J.H.
        • Working Group on Professional Issues
        European federation of internal medicine. The changing face of internal medicine: patient centred care.
        Eur J Intern Med. 2014; 25 (Feb): 125-127
        • Smyth H.
        • et al.
        Generalist vs specialist acute medical admissions - what is the impact of moving towards acute medical subspecialty admissions on efficacy of care provision?.
        Eur J Intern Med. 2022; 98 (Apr): 47-52
        • Pietrangelo A.
        Internists or specialists-that is the question!.
        Eur J Intern Med. 2022; 98 (Apr): 41-42
        • Levi M.
        Surprising outcomes of general internal medicine care versus specialty care in acutely admitted medical patients.
        Eur J Intern Med. 2022; 98 (Apr): 39-40