在启动无人入诊诊所后,急诊室中低急性患者数量的变化
Divya Kurian1, Vandana Sundaram2, Anna Graber Naidich2
1Department of Emergency Medicine Stanford University Palo Alto California USA.
一个步行诊所 (WIC) 最初减少了对低急性护理的急诊室 (ED) 访问. 然而,这种效果并没有持续长期,尽管WIC为这些患者提供了较低资源的环境.
科学领域:
- 医疗保健管理的管理
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
背景情况:
- 不定期的护理选项,包括步行诊所 (WIC),越来越多地用于管理患者流动.
- 紧急部门 (ED) 面临着拥挤的挑战,特别是在流感季节等高峰季节.
- WICs经常被实施,期望从ED转移低急性患者.
研究的目的:
- 评估ED-staffed WIC对低急性患者访问主ED的数量的影响.
- 为了确定WIC是否为非紧急情况的ED访问提供了持续的减少.
主要方法:
- 使用了回顾性队列研究设计.
- 在ED和WIC之间比较了患者和临床访问特征.
- 进行了中断时间序列分析,以评估WIC对低急性ED访问趋势的影响.
主要成果:
- 最初,WIC导致了低急性ED访问的显著减少 (P=0.01).
- 随着时间的推移,ED中的低急性患者数量趋向于WIC前的水平,在6,9或12个月后没有显著的持续影响 (P=0.07).
- 如果没有WIC,低急性访问将占ED总量的27%,而观察到的22.7%.
结论:
- 在WIC没有实现持久减少低急性患者向主要ED的数量.
- WIC提供了一个有价值的替代护理环境,允许紧急工作人员在高ED能力压力时期在资源密集度较低的环境中管理低急性病例.
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