通过加拿大阿尔伯塔省的急诊室流动,用于患有物质使用障碍的患者
Jonah Edmundson1, Kevin Skoblenick2,3, Rhonda J Rosychuk4
1The King's University, Department of Biology, Edmonton, Canada.
The western journal of emergency medicine
|August 1, 2023
概括
患有物质使用障碍 (SUD) 的患者在急诊室 (ED) 面临延误. 甲基胺使用和低收入显著减缓过渡,突出需要有针对性的干预措施,以改善这些人的ED流.
科学领域:
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
- 数据科学数据科学数据科学
背景情况:
- 自2016年以来,加拿大阿尔伯塔州的物质使用障碍 (SUD) 紧急诊所 (ED) 访问量有所增加,在COVID-19大流行期间有显著增加.
- 了解ED内的患者流动和延迟对于优化对SUD患者的护理至关重要.
研究的目的:
- 通过将其分解成不同的阶段来分析ED中SUD患者的停留时间 (LOS).
- 确定影响SUD患者在这些阶段之间过渡时间的因素.
主要方法:
- 从2019年4月到2020年3月,对阿尔伯塔居民的SUD进行了66,880次ED演示的回顾性分析.
- 使用了国际疾病分类第十次修订 (ICD-10) 代码对SUD.
- 采用多状态模型将ED LOS细分为八个状态,并评估对过渡时间的共变量影响.
主要成果:
- 总ED LOS的中位数为6小时13分钟.
- 甲基胺中毒 (METH) 和低收入状态与ED状态之间的过渡时间显著延长有关.
- 阿片类药物的使用与更快的过渡时间相关,而大都会EDs显示出更慢的释放/录取过程.
- 紧急救护人员拥挤严重影响了初始医生评估时间.
结论:
- 患有SUD的患者在ED访问期间遇到各种延迟,METH用户和来自低收入地区的患者经历了最显著的减速.
- 有针对性的战略,重点是改善METH中毒和来自弱势社会经济背景的患者的ED流.
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