Temporal Trends Over Ten Years in Formal Inpatient Gastroenterology Consultations at an Inner City Hospital

Abstract

GOALS: Inpatient consultation is an important, but poorly understood, component of medical subspecialty practices. In a time when all services strive for cost-effective and efficient treatments, little is known about the epidemiology of inpatient subspecialty consultation. This study is designed to describe the nature and trends of formal inpatient gastroenterology consultations during the past decade. STUDY: All inpatient gastroenterology consultations at Grady Memorial Hospital in Atlanta, GA, in 1998 and 1988 were retrospectively reviewed. Percentages of inpatient gastroenterology consultations were calculated for each year accordingly. Top ten reasons for inpatient gastroenterology consultations were compared. RESULTS: Formal inpatient gastroenterology consultations have steadily increased in the past 10 years (2.8% of all admissions in 1988 to 4.8% in 1998, < 0.0001). Inpatient gastrointestinal endoscopic procedures have significantly increased over the past decade (30.9% of the total consultations in 1988 to 36.1% in 1998, = 0.008). The leading reasons for formal inpatient gastroenterology consultations in 1998 were hematemesis, abnormal liver tests, hematochezia, anemia, and melena. Consultations for abnormal liver tests have significantly decreased in the past 10 years (27% of the total consultations in 1988 to 16% in 1998, < 0.001). CONCLUSIONS: Formal inpatient gastroenterology consultations and inpatient gastrointestinal endoscopic procedures have significantly increased over the past 10 years, despite pressures to decrease costs of inpatient care. The main reason for formal inpatient gastroenterology consultations shifted from abnormal liver tests to gastrointestinal bleeding.