减少低急症室出院对急诊室停留时间的影响是什么? 一个离散事件模拟建模研究
Hazel Squires1, Suzanne Mason2, Colin O'Keeffe2
1Sheffield Centre for Health and Related Research, The University of Sheffield, Sheffield, UK h.squires@sheffield.ac.uk.
Emergency medicine journal : EMJ
|October 31, 2023
概括
将低急性患者从急诊室 (ED) 转移到全科医院 (GP) 服务可以减少高急性患者的等待时间. 然而,仅凭这一战略不足以实现当前的ED目标.
科学领域:
- 医疗保健管理的管理
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 长时间的急诊室等待时间会对患者的治疗结果产生负面影响.
- 本研究评估了减少ED停留时间 (LOS) 的策略.
研究的目的:
- 评估防止低急性患者参观ED的效果.
- 评估在分拣时将低急性患者转移到同处的全科医院 (GP) 服务.
主要方法:
- 英国城市教学医院的离散事件模拟建模.
- 利用患者级数据库 (2015年5月至2016年4月),二次文献和专家诱导.
- 预测的LOS,4小时的基准成就,以及GP服务集成的成本效益.
主要成果:
- 将低急性患者转移到同处的全科医生 (9:00-17:00) 减少了高急性患者的LOS29分钟.
- 在4小时内看到的高急性患者的百分比从61%增加到67%.
- 估计每名患者的额外成本为6.76英;注意模型对输入变化的敏感性.
结论:
- 减少低急性ED护理人员影响高急性患者的LOS,这是由于共享资源的使用.
- 这一干预措施本身不足以实现目前的ED绩效目标.
- 模拟模型可适应进一步分析,以确定实现目标所需的变化.
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