[The medical care in internal medicine in relation to consultations]

To study the characteristics of interconsultations from Traumatology (TM), Urology (UR) and Psychiatry (PC) to Internal Medicine (IM).

Interconsultations from TM, UR and PC to IM from November 2000-April 2001 were analyzed. A medical care program was established and supervised by a physician specifically assigned for this purpose.

105 TM, 30 PC and 23 UR interconsultations were reported. The mean age and percentage of women were greater for the TM group. Hip fracture was the principal cause for hospital admission. Cardiac pathologies were the most frequently associated pathology. The mean Charlson Index was 6.07 (TM), 3.10 (PC) and 6.17 (UR). The principal cause for consultation was dyspnea. The most frequent diagnosis was respiratory infection. The mortality rates for the patients were 9.52% (TM), 13% (UR) and 0% (PC). When comparing rapid medical care for patients admitted to TM from 2000-2001 versus 1999-2000, we found the response to interconsultations to be most rapid. and 9.95% mortality for the 2000-2001 period versus 13.84% mortality for the 1999-2000 period.

The TM interconsultations proved to be both complex and frequent. The majority of interconsultations were for elderly women with hip fractures and multiple pathologies requiring rapid medical assistance. A response system adapted to these interconsultations improved the quality of care and mortality.