Background: Rapid access Internal Medicine (IM) clinics aim to reduce burden on inpatient services. Despite an increased prevalence of these clinics across Canada, there is a lack of evidence demonstrating their value.Methods: An observational retrospective review was undertaken to identify the usage of our IM clinic. A prospective analysis of Internal Medicine Clinical Teaching Unit (CTU) diverted admissions and a subsequent cost benefit analysis was performed.Results: Referrals were primarily from emergency room physicians (47%) and general practitioners (34%). Of the requests for admission over a 4 week period, 6.1% were diverted with clinic follow-up within four days. Over $30,000 of inpatient care costs were prevented over the study period.Conclusion: Rapid access IM clinics help reduce demand on emergency departments and inpatient services. A significant percentage of hospital admissions may be avoided by implementing rapid access clinics. Further study is needed to better quantify the overall benefit.
Mumps is a viral infection endemic in North America despite widespread vaccination. Typical symptoms include parotitis, fever, and myalgias; however, absence of parotitis and asymptomatic infection is common. Complications are rare, occurring in 10% or fewer of patients, and have only rarely been described since widespread adoption of the mumps vaccine. Most complications occur in non-vaccinated individuals. Myocarditis is a very rare, but clinically significant, complication of acute mumps infection. We report a case of acute myocarditis with a serological diagnosis of acute mumps infection in a previously healthy, vaccinated 24-year-old female.
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