Complexity in internal medicine wards: A novel screening method and implications for management.

Area of Science:

• Healthcare management
• Clinical assessment
• Patient complexity

Background:

• Healthcare complexity is a growing concern, yet practical assessment tools are lacking.
• Hospitals face challenges in managing patient complexity effectively.
• Identifying complex patients is crucial for optimizing care and resource allocation.

Purpose of the Study:

• To validate a novel screening method for identifying patients with complex hospitalization events.
• To determine the prevalence and characteristics of complex patients.
• To compare complex patients with non-complex patients and those with multimorbidities.

Main Methods:

• A simple screening method using objective and subjective criteria was applied.
• 240 internal medicine patients in Tuscany were monitored over 56 days.
• Demographic features, length of stay, and prognosis were compared between groups.

Main Results:

• 28.8% of patients experienced complex hospitalization episodes.
• Complex patients were younger, more comorbid, stayed longer (+4.5 days), and had higher mortality (OR: 24.93).
• Complex patients had a lower probability of discharge home (OR: 0.25).

Conclusions:

• A simple screening method can identify complex patients in internal medicine wards.
• Approximately one-third of patients are complex daily.
• Findings support dynamic management strategies for patients with varying complexity levels.