高灵敏度热素心脏路径基于临床决策协议对观察访问的影响
George B Hughes1, Iyesatta Emeli1, Matthew A Wheatley1
1From the Department of Emergency Medicine.
在胸痛方案中实施高灵敏度素 (hs-cTn) 减少了观察访问和成本,但没有增加住院患者的入院. 这项研究表明hs-cTn可以优化胸痛管理中的资源利用.
科学领域:
- 心脏病学 心脏病学
- 临床诊断 临床诊断 临床诊断
- 医疗保健服务研究 医疗服务研究
背景情况:
- 高灵敏度素 (hs-cTn) 试验可能会增加异常结果,可能导致更多的医院观察访问.
- 在胸痛临床决策协议 (CDP) 中hs-cTn整合对医疗保健资源利用的影响需要调查.
研究的目的:
- 评估将hs-cTn纳入胸痛CDP对学术卫生系统内观察访问量的影响.
- 评估hs-cTn协议实施后成本,观察时间和住院患者入院率的变化.
主要方法:
- 一项回顾性观察队列研究分析了24个月内在4家医院进行6712次胸痛观察访问.
- 在标准化急诊室胸痛协议 (HEART途径,串行素) 中实施hs-cTn协议之前和之后的结果进行了比较.
- 从系统数据仓库中提取了每日人口普查,成本,观察时间和住院率的数据.
主要成果:
- 实施后,每日胸痛观察人口普查下降了28%,胸痛观察访问的比例下降了22%.
- 胸痛观察的每日直接费用减少了4313美元,每日总睡眠时间减少了41.5小时.
- 胸痛患者的每日住院住院率保持不变.
结论:
- 实施hs-cTn胸痛协议显著减少了观察访问和相关成本和资源利用.
- 这项研究表明,hs-cTn集成可以优化胸痛管理途径,而不会影响患者的安全或增加住院患者的入院.
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