Use of diagnostic tests in problems of internal medicine. Analysis of 1,667 ambulatory patients attending the first aid unit of a general hospital
Natangelo, R.; Riva, R.; Subert, R.
Minerva Medica 78(17): 1313-1319
1987
ISSN/ISBN: 0026-4806 PMID: 3313112 Document Number: 291755
Patients with problems of internal medicine presenting at first-aid units of city hospitals represent a considerable work load. 1667 patients of this type have been examined retrospectively. The most numerous group had cardiocirculatory (22%) and nervous system (21%) problems, 9% had problems linked to their mental state and 11% dermatology complaints in general. 1047 patients underwent further investigation and/or specialist examination (247 neurological and 166 cardiological). Patients with jaundice, diabetes mellitus and cardiac decompensation underwent the highest number of laboratory examinations. The highest percentage of X-rays was done on patients suffering from chronic bronchitis during an acute episode, the highest percentage of ECGs in patients with prethoracic pain or cardiopalmus. In first aid also, some tests seem to be carried out as routine or for legal medicine purposes while for problems where tests are less easy or harder to understand (e.g. loss of consciousness episodes), a specialist is frequently brought in. The work load on the first-aid out-patients structure can be reduced by promoting greater awareness of the problem on the part of the internist and by rerouting users to non-hospital structures.