The profile of complex chronic and polypathological patients hospitalized in internal medicine services has changed in recent years. According to the Spanish Society of Internal Medicine (SEMI), a 61% of patients admitted to internal medicine are complex chronic.
Due to the aging of the population, they are now older, more functionally impaired, more dependent and have a higher prognostic risk stratification.
Experts agree that “it is important to avoid hospitalization as much as possible, as the loss of functionality that occurs during the hospitalization of these patients has been demonstrated” and to promote special programs of care during admission to avoid both functional deterioration and help with fragmentation.
What kind of patients are admitted to internal medicine?
These are patients with a large burden of chronic diseases, generally older, often weak, reduced in size personal autonomy, functional and cognitive impairment, polypharmacy, and with great needs for social support and socio-health resources.
On the other hand, a multipathological patient is one with two or more complex chronic diseases that develop over the years, mostly from a group of pathologies characterized by a significant deterioration in the quality of life.
Las the most common pathologies of complex chronic patients with more pathologies admitted to the Internal Medicine Service are heart diseases (68%), followed by chronic kidney diseases (49%), neurological diseases (43%) and diseases of the respiratory system (32%). And 60% have a high degree of dependence on basic activities of daily living (ABCV).
In order to help and provide assistance to this type of patient, SEMI determines that a individualized and joint plan between different levels of care that promotes patient or caregiver empowerment.
It is important to avoid hospitalization as much as possible because the loss of functionality that occurs during hospitalization has been proven. Doctors consider it important to promote coordination and continuity of care between different levels of care, primary health care and social health centers. The goal is always to improve the quality of care for these patients, especially in transitions of care.
Chronicity is a pandemic that requires generalists with clinical skills, human and organizational in order to provide an appropriate response to the people who suffer from it. Therefore, continuous training of internists is necessary for continuous improvement of care for people with complex chronic diseases.