病院の急増能力の構築のための入院処置分類:多段階の研究
Gabor D Kelen1, Chadd K Kraus, Melissa L McCarthy
1Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD 21287, USA. gkelen@jhmi.edu
Lancet (London, England)
|December 5, 2006
まとめ
新しい5つのカテゴリーシステムにより,入院患者は,病院の急増中に安全な早期出院のために分類されます. このリバーストリアージのアプローチは,退院のための低リスクの個人を特定することによって,増加した患者数を管理するのに役立ちます.
科学分野:
- 医療システム管理 医療システム管理
- 災害への備えについて
- 患者さんの気分の調子.
背景:
- 医療制度は,緊急時における患者数の管理に課題に直面しています.
- 入院患者の安全な早期退院 (リバーストリアージ) は,病院の急増容量を増やすことができます.
- リスクに基づいて退院する患者を分類するシステムが必要である.
研究 の 目的:
- 早期出院の適性に基づいて入院患者を分類するための処分分類システムを開発する.
- 早期出院後の有害事象に対するリスク耐性を評価する.
主な方法:
- 戦争分析の実験室演習が行われました.
- 証拠に基づいた技術と39人の専門家パネルの参加によるコンセンサスプロセスが使用されました.
- パネルメンバーは,カテゴリーを定義し,リスク耐性を割り当て,重要な介入を特定し,排水リスクをランク付けしました.
主要な成果:
- 5つのカテゴリーに分類された処分分類制度が満場一致で合意されました.
- 有害事象に対するリスク耐性は,最も低いリスクグループでは<4%から,最も高いリスクグループでは100%まででした.
- 28の重要な介入が特定され,その介入が中止された場合,有害事象が発生する可能性は様々であった.
結論:
- 開発されたシステムは,要求の急増時に早期退院を含む,安全な処分のために患者を概念的に分類します.
- このシステム内のリアルタイムの患者分類のための臨床基準は,まだ必要である.
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