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Introduction This study was promoted by Sociedad Castellano Manchega de Endocrinologia, Nutricion y Diabetes to ascertain the characteristics of patients seen at the outpatient clinics of endocrinology and nutrition of the Castilla-La Mancha Health Authority and the case mix of diagnoses. Patients and Methods This was a retrospective, cross-sectional study of the activity of the endocrinology and nutrition outpatient clinics of public hospitals of Castile-La Mancha during 2018. All visits made on 10% of the working days were analyzed. Data collected comprised patient age and sex, whether a first or subsequent had been made, and whether this was face-to-face or not, and up to five diagnoses per visit. Results A total of 10,709 visits with a subsequent/first visit ratio of 3.4 were analyzed. Patient age was 52.1?±?18.2 years, and 67.1% were women. Type 2 diabetes mellitus, primary hypothyroidism, thyroid nodular disease, and obesity/overweight were the most common conditions recorded as first diagnosis, accounting for more than half of the total number of visits. Type 1 diabetes mellitus and thyroid cancer were the diagnoses in which the subsequent/first visit ratio was greater. Type 2 diabetes mellitus, obesity, and primary hypothyroidism accounted for almost half of the first visits. Conclusions A wide variety of conditions were seen, some of which are among the most prevalent in the general population, while others are not so prevalent, but are complex and difficult to manage by other specialties. Improved knowledge and analysis of the data should allow for the identification of opportunities for improvement and for the implementation of specific actions.

Introduction The activity of an Endocrinology and Nutrition (E&N) department consists of inpatient care both by those attached to the department and through consultations with specialists from other departments. The inpatient care activity of all the E&N departments of a public health system has not been studied in Spain. Material and methods This was a retrospective study of hospital ward activity during 2018 of the E&N departments of the Castilla-La Mancha Public Health Service. It was undertaken in order to ascertain the characteristics of the patients attended to, both by those in charge of the E&N departments and through interconsultation with other departments, as well as the case-mix of the pathology of these patients. All patients admitted to E&N and a 10% sample of those treated through interconsultation were analysed. Results 261 admissions were recorded for Castilla-La Mancha Public Health Service E&N departments. 82.8% were urgent and 53.7% were due to type 1 diabetes mellitus. A total of 5955 patients were seen on an interconsultation basis, 591 of whom were analysed. The most frequent reason for interconsultation was diabetes mellitus/hyperglucemia (28.8%), requiring 6.1 ± 6.7 days per patient. However, interconsultations for artificial nutrition required more days of attendance per patient and accounted for a higher percentage of the total number of days of interconsultation (60.4%). Conclusions The inpatient care activity of the E&N departments of Castilla-La Mancha Public Health Service mainly consists of attending to patients with chronic pathologies of high hospital prevalence such as diabetes mellitus/hyperglucemia and, especially, clinical nutrition.

Introduction The tools for analyzing the case-mix in outpatient care are scarce and unsatisfactory. The objective of this work by the Sociedad Castellano Manchega de Endocrinologia, Nutricion y Diabetes (SCAMEND) was the development of a tool that allows to analyze the the case-mix in outpatient care in Endocrinology and Nutrition considering the complexity of the patient disease. Material and methods The SCAMEND index of complexity in outpatient care in Endocrinology and Nutrition (ISCCE-EyN) was defined using the Delphi method with two rounds between endocrinologists, comparing the complexity of each consult with that of a review visit of primary hypothyroidism. Results The first visits were considered more complex than the successive visits. Non-neoplastic thyroid pathology and uncomplicated overweight/obesity were considered the least complex diseases, while metabolopathies, multiple endocrine neoplasm syndromes and adrenal carcinoma were considered the most complex. The degree of consensus was high in most of the diseases analyzed. Conclusions We present a tool that allows to analyze the case-mix in outpatient care in Endocrinology and Nutrition considering the inherent complexity of the disease of the patient attended. This tool can be used to make comparisons between centres, to better allocate resources within a given service or for self-evaluation.