Does admission to a department of internal medicine improve patients' quality of life? 1998

B O Eriksen, and I S Kristiansen, and E Nord, and J F Pape, and S M Almdahl, and A Hensrud, and S Jaeger, and F A Mürer, and R Robertsen, and G Thorsen
Department of Medicine, University Hospital of Tromsø, Norway. medboe@rito.no

OBJECTIVE The Tromsø Medical Department Health Benefit Study was designed to estimate health gains from admissions to a department of internal medicine. We have previously reported that the hospital stays had no effect on the life expectancy of 61% of the patients. However, it has been claimed that modern medicine has a greater effect on quality of life (QoL) than on life expectancy. The aim of the present study was to investigate this issue by estimating gains in QoL for patients admitted to a department of internal medicine. METHODS The time trade-off method (TTO) was used for assessing QoL gain from consecutive admissions during a 6-week period. The assessments were made by one of two expert panels, each consisting of an internist, a surgeon and a general practitioner, on the basis of summaries of all relevant clinical information about the patients. Short-term improvements in QoL during the stay or shortly after discharge were scored on an ordinal scale. RESULTS Of the admitted patients, 41% had gains in QoL measured with the TTO (mean gain = 0.06; 95% confidence interval = 0.05-0.07; n = 422), and eight of these had gains equal to or greater than 0.50. Another 40% had gains in health-related short-term QoL measured with the ordinal scale. In a multivariate linear regression analysis, emergency admissions, high age and the disease categories 'endocrinological diseases' and 'pneumonia and influenza', were associated with higher gain, and 'undiagnosed symptoms' and 'cerebrovascular diseases' with lower gain. CONCLUSIONS As judged by the expert panels, the investigated department of internal medicine was effective in improving the QoL of 81% of the admitted patients. Whilst most of the patients achieved small gains, a minority had gains in QoL corresponding to the treatment of life-threatening diseases.

UI MeSH Term Description Entries
D007388 Internal Medicine A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. General Internal Medicine,Medicine, Internal,Internal Medicine, General,Medicine, General Internal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010343 Patient Admission The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution. Voluntary Admission,Admission, Patient,Admission, Voluntary,Admissions, Patient,Admissions, Voluntary,Patient Admissions,Voluntary Admissions
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D005260 Female Females
D006305 Health Status Indicators The measurement of the health status for a given population using a variety of indices, including morbidity, mortality, and available health resources. Health Risk Appraisal,Health Status Index,Health Status Indexes,Appraisal, Health Risk,Appraisals, Health Risk,Health Risk Appraisals,Health Status Indicator,Health Status Indices,Index, Health Status,Indexes, Health Status,Indicator, Health Status,Indicators, Health Status,Indices, Health Status,Risk Appraisal, Health,Risk Appraisals, Health
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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