RECALMIN V. Evolution in the activity of internal medicine units of the National Health System (2007-2022)

To analyse the structure, activity and results of the Internal Medicine Units (IMUs) of the Spanish National Health System (SNHS). To compare the results of the RECALMIN 2023 survey with previous waves of surveys of the UMIs (2008, 2015, 2017, 2019. 2021) and to analyse trends in the structure, activity and results of the UMIs.

Two data sources: 1) survey on UMI structure and activity; and 2) Hospital discharges of UMIs from the Minimum and Basic Data Set (CMBD) of the SNHS. Cross-sectional descriptive study of the UMIs in acute hospitals of the SNHS with data referring to 2022, comparing them with previous studies.

Over the period 2007-2022, the rate of internists per 100,000 inhabitants increased (IRR: 4.5%; p < 0.001). Inpatient discharges per population and the number of discharges by UMI (IRR: 2.6%; p < 0.005; IRR: 3.5%; p < 0.001, respectively) also increased. The UMIs account for 20% of discharges from general hospitals in the NHS. The SEMI has a database of the CMBD_MIN 2007-2022 with 9,931,401 discharges given by the UMI. The crude in-hospital hospital mortality rate increased in the period 2007-2022 (p < 0.001). From 2020 onwards (SARS-CoV-2 pandemic) overall risk-adjusted and process-adjusted mortality increased (p < 0.001).

UMIs have a central position in SNHS hospital care. The activity of the UMI has grown significantly in the period analysed. The RECALMIN project identifies strengths and opportunities to be strategically addressed by SEMI.