[Prevalence of diagnoses in ambulatory and hospitalized patients]

Prevalence and distribution of different clinical presentations were analyzed in 6000 hospitalized and ambulatory patients. One medical University clinic and three further hospital units, two university outpatient clinics and four practitioners participated. 6000 main diagnoses and 2560 additional diagnoses had been recorded. The mean age was 64 for the hospitalized patients, 50 years for the outpatient clinic and 47 years at the doctors' office. Cardiovascular diseases were most common. This group of diagnoses was twice as common in hospitalized patients (40.9%) than in the ambulatory group: 19.5% (outpatient clinic) and 15.2% (private practice). In contrast, psychiatric diagnoses were 5 times more frequent in the practice than in the hospital (11.6% vs. 2.4%) and musculoskeletal diseases were even 7 times more common in the practice (13.3% vs. 1.9). 93% of the hospitalized patients had one of the 25 most prevalent diagnoses. This percentage was substantially lower in patients of the outpatient clinic (73%) and of private practice (64%). An additional diagnosis was posed for every other patient in the hospital or at the outpatient clinic, in the practitioners office only for every fourth patient. The analysis shows that hospitalized patients often have a different set of diagnoses than ambulatory ones. To guarantee a broad internistic training outpatient clinics are of great importance. A part of internistic education, however, can also be obtained by cooperation with practitioners.