Effects of Co-management of the Neurosurgery Department by General Physicians
10.14442/generalist.45.74
- VernacularTitle:総合診療医の脳神経外科患者に対するCo-managementの効果
- Author:
Hiroyuki YAMAMOTO
;
Kentaro KAMEDA
;
Mamoru KOMATSU
;
Takeshi YOSHIHIRO
;
Shouhei NOSHIRO
;
Masafumi OHTAKI
- Keywords:
Co-management;
General Physician;
Neurosurgery;
Quality of healthcare
- From:An Official Journal of the Japan Primary Care Association
2022;45(3):74-81
- CountryJapan
- Language:Japanese
-
Abstract:
Introduction: This study evaluated the effectiveness of co-management of the neurosurgery department by general physicians.Methods: A retrospective observational study was conducted in a tertiary hospital. Length of stay, in-hospital mortality, number of transfers to the intensive care unit (ICU) due to emergency medical problems, prescription sharing ratio with neurosurgeon, and impression reported by nurses were evaluated by comparing one year before and after the co-management of the neurosurgery department was initiated.Results: Length of stay (Median 14 days, 14 days), mortality rate (7.58%, 5.75%) and transfer rate for ICU (3.23%, 1.94%) were not significantly different between one year before and one year after, respectively. Subgroup analysis of patients over 70 years of age hospitalized for cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage showed that the number of patients transferred to the ICU due to medical problems associated with internal medicine significantly decreased (P = 0.04). A general physician was responsible for half of the prescriptions. The nurse's report was highly positive.Conclusion: Co-management of the neurosurgery department by general physicians did not have a significant effect on reducing length of stay or mortality rate; however, we found a decrease in the number of patients transferred to the ICU due to medical problems among elderly stroke patients.
