在轮班变化和扭曲紧急病人的感知和治疗中的分类
1DEMM, University of Milan, Italy.
Journal of health economics
|December 10, 2024
概括
在轮班期间,分组护士变得更加宽容,导致轮班变更后到达的患者的优先级降低. 这影响了患者的护理,需要进一步的紧急治疗,突出了紧急评估中的偏见.
科学领域:
- 医疗保健管理的管理
- 护理实践 护理实践
- 医疗保健服务研究 医疗服务研究
背景情况:
- 紧急诊所 (ED) 的患者流动是复杂的,受到许多因素的影响.
- 准确的患者分组对于及时和适当的医疗护理至关重要.
- 了解护理评估中的潜在偏见对于改善患者的治疗结果至关重要.
研究的目的:
- 识别和量化急诊室分拣护士患者状况评估中的扭曲.
- 调查这些分类扭曲对患者护理的短期和中期后果.
- 检查护士的班次时间如何影响患者的优先级和随后的医疗照顾.
主要方法:
- 利用了超过200万个急诊室记录的大数据集.
- 采用机器学习算法与回归不连续性设计相结合.
- 分析了患者分组数据,以检测护理班次评估宽容的系统变化.
主要成果:
- 记录了护士在整个班次的分拣宽容度的逐步增加.
- 发现,轮班换班后立即到达的患者的优先级较低.
- 观察到,这些患者得到的护理不足于最佳,并且在初次访问后需要额外的紧急医疗服务.
结论:
- 鉴定护士对患者紧急情况的评估可能会受到变化的影响,因为他们的班次进展.
- 这些扭曲会导致患者护理的差异和不良健康事件.
- 最初的紧急性评估显著影响了医务人员随后的看法和患者管理.
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