从紧急部门观察单位出院后返回:谁,什么,什么时候,为什么?
Daniel Berger1, Steven King1, Catherine Caldwell1
1Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
The western journal of emergency medicine
|June 6, 2023
概括
紧急部门观察单位 (EDOU) 的回报率低于10%,大多数与初次访问有关. 在这些回报中,只有不到5%的回报是可以避免的,这为质量改进提供了洞察力.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 紧急部门观察单位 (EDOU) 和观察停留的利用正在增加.
- 关于在EDOU出院后返回急诊室 (ED) 的患者特征的数据有限.
研究的目的:
- 从EDOU出院后14天内返回ED的患者的特征.
- 为了识别与EDOU释放后非计划的ED返回相关的因素.
主要方法:
- 在2018年1月至2020年6月期间从学术医疗中心的EDOU出院的患者的回顾性图表审查.
- 排除从EDOU入院的患者,违背医疗建议离开或在EDOU中死亡的患者.
- 手动提取人口统计,并发症和医疗保健利用数据;医生审查以确定访问相关性和可避免性.
主要成果:
- 在4179个EDOU入院中,在EDOU放电后14天内发生了333次计划外ED返回 (9.4%).
- 对喘治疗的患者观察到更高的复发率;对于胸痛或昏迷的患者观察到更低的复发率.
- 医生审查人员发现64.6%的回报与索引访问有关,4.5%可能可以避免,其中53.3%的可避免回报是在出院后48小时内发生的.
结论:
- 该研究发现EDOU的整体回报率低于10%.
- 大约三分之二的回报与索引EDOU访问有关.
- 只有不到5%的回报被认为是可能避免的,这突出了质量改善举措的机会.
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