The Value of a Rapid Access Internal Medicine Clinic – An Observational Perspective

Main Article Content

Ryan Joseph LeBlanc
Karmen Jongewaard
Laura Farrell


Ambulatory, Clinic, Internal Medicine, Rapid Access


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.

Abstract 1233 | pdf Downloads 556 HTML Downloads 150


Tran DT, Ohinmaa A, Thanh XN, et al. The current and future financial burden of hospital admission for heart failure in Canada: a cost analysis. CMAJ Open 2016. 4(3): E365-70

Top 5 reasons for hospital admissions. Ottawa: Canada Institute for Health Information; 2017. Available here: Accessed: June 5, 2017

Levy R. Improving Outcomes by Redirecting Care to Rapid Access Internal Medicine Clinics. March 2017 [Internet]. Available here: Accessed: August 18, 2017

Peukert T, McDonell G, Craig J. Can A Rapid Access Neurology Clinic Reduce A&E Admissions? J Neurol Neurosurg Psychiatry 2014; 84: e4.

Yuyun MF, Loke I, Nicholson WB, Clayton L, Squire IB. Secondary Care Rapid Access Heart Failure Clinics for Reduction in Hospitalisation. J Cardiol Clin Res 2016. 4(3): 1062-68

Guthrie B, Davies H, Greig G, et al. Delivering health care through managed clinical networks (MCNs): lessons from the North. Report for the National Institute for Health Research Service Delivery and Organisation Programme, 2010. National Institute for Health Research website. Available here: Accessed: August 18, 2017

Shen E, Koyama SY, Huynh DN, et al. Association of a Dedicated Post-Hospital Discharge Follow-Up Visit and 30-Day Readmission Risk in a Medicare Advantage Population. JAMA Internal Medicine 2017. 117(1): 132-135

Similar Articles

You may also start an advanced similarity search for this article.