What do general medicine perioperative services do? A Victorian multicentre cross-sectional study

Area of Science:

• General medicine
• Perioperative care
• Health services research

Background:

• General medicine perioperative services manage referrals from various surgical specialties.
• These services care for older, comorbid, frail, and high-risk surgical patients.
• The role of general physicians in perioperative care is diverse.

Purpose of the Study:

• To evaluate different models of general medicine perioperative services.
• To describe the characteristics of patients referred to these services.
• To analyze the outcomes associated with perioperative referrals.

Main Methods:

• A multicenter, cross-sectional study was conducted across 11 Victorian public hospitals.
• Adult patient referrals (≥18 years) from all surgical services were included.
• Comparative analyses of outcomes based on care models were performed, adjusted for covariates.

Main Results:

• The study analyzed 1071 referrals, with a median patient age of 73 years and a high comorbidity index.
• Common requests included preoperative risk assessment, postoperative complication management, and diagnostic input.
• Proactive care models were linked to fewer medical emergency team (MET) calls, shorter hospital stays, and higher return-to-residence rates.

Conclusions:

• General medicine perioperative services are vital for high-risk surgical patients.
• Proactive care models demonstrate potential for improved patient outcomes.
• Well-resourced perioperative services may enhance patient care and reduce adverse events.