TY - JOUR
T1 - Complexity in hospital internal medicine departments
T2 - What are we talking about?
AU - Nardi, Roberto
AU - Berti, Franco
AU - Greco, Antonio
AU - Scanelli, Giovanni
AU - Leandri, Paolo
AU - Reta, Massimo
AU - Mazzetti, Magda
AU - Pasquale, Angelo
AU - Belmonte, Gelorma
AU - Magnani, Mirco
AU - Frasson, Stefania
AU - Baldo, Concetta
AU - Gussoni, Gualberto
AU - Vescovo, Giorgio
AU - Regina, Micaela La
AU - Campanini, Mauro
AU - Iori, Ido
AU - Mathieu, Giovanni
AU - Mazzone, Antonino
AU - Nozzoli, Carlo
PY - 2013
Y1 - 2013
N2 - Internal medicine (IM) patients are mostly elderly, with multiple complex co-morbidities, usually chronic. The complexity of these patients involves the intricate entanglement of two or more systems (e.g. body and disease, family-socio-economic and environmental status, coordination of care and therapies) and this requires comprehensive, multi-dimensional assessment (MDA). Despite attempts to improve management of chronic conditions, and the availability of several MDA tools, defining the complex patient is still problematic. The complex profile of our patients can only be described through the best assessment tools designed to identify their characteristics. In order to do this, the Federation of Associations of Hospital Doctors on Internal Medicine FADOI has created its own vision of IM. This involves understanding the different needs of the patient, and analyzing diseases clusters and the possible relationships between them. By exploring the real complexity of our patients and selecting their real needs, we can exercise holistic, anthropological and appropriate choices for their treatment and care. A simpler assessment approach must be adopted for our complex patients, and alternative tools should be used to improve clinical evaluation and prognostic stratification in a hierarchical selection of priorities. Further investigation of complex patients admitted to IM wards is needed.
AB - Internal medicine (IM) patients are mostly elderly, with multiple complex co-morbidities, usually chronic. The complexity of these patients involves the intricate entanglement of two or more systems (e.g. body and disease, family-socio-economic and environmental status, coordination of care and therapies) and this requires comprehensive, multi-dimensional assessment (MDA). Despite attempts to improve management of chronic conditions, and the availability of several MDA tools, defining the complex patient is still problematic. The complex profile of our patients can only be described through the best assessment tools designed to identify their characteristics. In order to do this, the Federation of Associations of Hospital Doctors on Internal Medicine FADOI has created its own vision of IM. This involves understanding the different needs of the patient, and analyzing diseases clusters and the possible relationships between them. By exploring the real complexity of our patients and selecting their real needs, we can exercise holistic, anthropological and appropriate choices for their treatment and care. A simpler assessment approach must be adopted for our complex patients, and alternative tools should be used to improve clinical evaluation and prognostic stratification in a hierarchical selection of priorities. Further investigation of complex patients admitted to IM wards is needed.
KW - Assessment
KW - Comorbidity
KW - Complexity
KW - Frailty
KW - Internal medicine patient
KW - Multimorbidity
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U2 - 10.4081/itjm.2013.142
DO - 10.4081/itjm.2013.142
M3 - Article
AN - SCOPUS:84879747058
VL - 7
SP - 142
EP - 155
JO - Italian Journal of Medicine
JF - Italian Journal of Medicine
SN - 1877-9344
IS - 3
ER -