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AB1061 Implementation of A Weekly Consultation of Emergency Room Patients in Patients with Rheumatic and Musculoskeletal Diseases
  1. J.A. Roman Ivorra,
  2. C. Nuñez-Cornejo Piquer,
  3. I. Chalmeta Verdejo,
  4. C. Molina Almela,
  5. E. Grau Garcia,
  6. I. Martinez Cordellat,
  7. C. Feced Olmos,
  8. C. Alcañiz Escandell,
  9. L. Gonzalez Puig,
  10. R. Negueroles Albuixech,
  11. M.L. Muñoz Guillen,
  12. J.L. Valero Sanz,
  13. J. Ivorra Cortes
  1. Department Of Rheumatology, Hospital Universitario Y Politécnico La Fe, Valencia, Spain

Abstract

Background Rheumatic and musculoskeletal diseases (RMD) in the La Fe Department are assessed by Primary Care, and then referred to the Specialty Center for diagnosis and monitoring by the rheumatologist. However, due to the possible delay between the Primary Care visits and consultation in the Specialty Center, the patient repeatedly comes to the Emergency Room (ER), resulting in inappropriate hospitalizations. Therefore, the Department of Rheumatology has established a Weekly Consultation of patients referred from the Emergency Room (WEC) where the rheumatologist evaluates these RMD.

Objectives To analyze the impact of implementing the WEC on reducing inappropriate hospital admissions in patients with RMD.

Methods During 2011, the WEC was implemented and in 2012 it was fully operational. We collected data from hospitalizations and costs for annuities in 2010, 2011 and 2012 from RMD patients directly seen in the ER and those that were evaluated in the WEC.

Results Hospitalizations fromRMD decreased from 83 in 2010 to 47 in 2012 with implementation of the WEC, reducing the average number of days of hospitalization from 10.15 to 7.5. The most common diseases were low back pain and sciatic lumbar pain, which in 2011 had a shorter hospital stay in cases managed using the WEC (7 and 5 days, respectively) than cases that were not managed by Rheumatology (12 and 11 days). It also resulted in a decrease in healthcare costs derived from admissions for all pathologies. In 2012, all proposals of RMD were derived to WEC. In 2012 it can assess the impact of this new strategy again in sciatic lumbar pain and low back pain, reducing the average length of hospitalization to 8 and 7 days, respectively, and total hospitalization days by 49% (106 days) and 58% (213 days), respectively. Costs also decreased significantly, resulting in a savings in health expenditures of 41% (€20,764.7) for low back pain and 52% (€44,206.6) for lumbar sciatic pain.

Conclusions With this strategy, we can conclude that it has been possible to reduce the number of admissions due to rheumatic and musculoskeletal diseases with the same resources available to the Department of Rheumatology. This speeds up diagnosis and care and benefits patients. Furthermore, it also reduces the length of hospital stays and resulting hospital costs.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.5020

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