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International perspectives on general internal medicine and the case for "globalization" of a discipline.

ABSTRACT: General internal medicine (GIM) has flourished in the United States (U.S.). Unlike other subspecialties of internal medicine, however, GIM's evolution has not been global in scope, but rather appears to have occurred in isolation within countries. Here, we describe international models of GIM from Canada, Switzerland, Australia/New Zealand, Argentina, and Japan, and compare these with the U.S. model. There are notable differences in the typical clinical roles assumed by General Internists across these 7 countries, but also important overlap in clinical and academic domains. Despite this overlap, there has been a relative lack of contact among General Internists from these and other countries at a truly international GIM meeting; the time is now for increased international exchange and the "globalization" of GIM.

SUBMITTER: Ghali WA

PROVIDER: S-EPMC1484665 | biostudies-literature | 2006 Feb

REPOSITORIES: biostudies-literature

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International perspectives on general internal medicine and the case for "globalization" of a discipline.

Ghali William A WA Greenberg Peter B PB Mejia Raul R Otaki Junji J Cornuz Jacques J

Journal of general internal medicine 20051207 2

General internal medicine (GIM) has flourished in the United States (U.S.). Unlike other subspecialties of internal medicine, however, GIM's evolution has not been global in scope, but rather appears to have occurred in isolation within countries. Here, we describe international models of GIM from Canada, Switzerland, Australia/New Zealand, Argentina, and Japan, and compare these with the U.S. model. There are notable differences in the typical clinical roles assumed by General Internists across ...[more]

PMID: 16336623

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Project description:BackgroundPeople who are homeless have a higher burden of illness and higher rates of hospital admission and readmission compared to the general population. Identifying the factors associated with hospital readmission could help healthcare providers and policymakers improve post-discharge care for homeless patients.ObjectiveTo identify factors associated with hospital readmission within 90 days of discharge from a general internal medicine unit among patients experiencing homelessness.DesignThis prospective observational study was conducted at an urban academic teaching hospital in Toronto, Canada. Interviewer-administered questionnaires and chart reviews were completed to assess medical, social, processes of care, and hospitalization data. Multivariable logistic regression with backward selection was used to identify factors associated with a subsequent readmission and estimate odds ratios and 95% confidence intervals.ParticipantsAdults (N = 129) who were admitted to the general internal medicine service between November 2017 and November 2018 and who were homeless at the time of admission.Main measuresUnplanned all-cause readmission to the study hospital within 90 days of discharge.Key resultsThirty-five of 129 participants (27.1%) were readmitted within 90 days of discharge. Factors associated with lower odds of readmission included having an active case manager (adjusted odds ratios [aOR]: 0.31, 95% CI, 0.13-0.76), having informal support such as friends and family (aOR: 0.25, 95% CI, 0.08-0.78), and sending a copy of the patient's discharge plan to a primary care physician who had cared for the patient within the last year (aOR: 0.44, 95% CI, 0.17-1.16). A higher number of medications prescribed at discharge was associated with higher odds of readmission (aOR: 1.12, 95% CI, 1.02-1.23).ConclusionInterventions to reduce hospital readmission for people who are homeless should evaluate tailored discharge planning and dedicated resources to support implementation of these plans in the community.

Dataset Information

International perspectives on general internal medicine and the case for "globalization" of a discipline.

Publications

International perspectives on general internal medicine and the case for "globalization" of a discipline.

Similar Datasets

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