急诊室停留时间对住院患者利用率和死亡率的影响
Kai-Jie Ma1, Yi-Chen Hsu2, Wei-Wen Pan3
1Department of Public Health, China Medical University, Taichung, 406040, Taiwan.
Health economics review
|February 19, 2025
概括
长时间停留在急诊室 (ED) 会增加住院时间和死亡风险. 减少ED等待时间对于更好的患者结果和高效的医疗资源使用至关重要.
科学领域:
- 医疗保健管理的管理
- 临床结果研究研究
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在台湾,急诊室 (ED) 的拥挤问题越来越令人担忧,导致患者停留时间延长.
- 国际研究将长时间的ED停留与不良的医疗保健成本和患者结果联系在一起,但来自台湾的数据有限.
- 本研究调查了ED停留时间对台湾住院患者资源利用率和死亡风险的影响.
研究的目的:
- 分析急诊室 (ED) 住院时间和随后的住院时间之间的关联.
- 评估ED停留时间和住院患者死亡风险之间的关系.
- 检查ED停留时间对住院费用的影响.
主要方法:
- 分析了台湾中央医疗中心42139名患者的数据.
- 一般化估计方程 (GEE) 用于评估住院时间和费用.
- 后勤回归用于评估住院后的死亡风险.
主要成果:
- 较长的ED停留与增加的住院时间相关:在ED24-48小时增加2.27天,和≥48小时增加3.22天 (P<0.001).
- 对于24-48小时 (OR=1.73) 和≥48小时 (OR=2.23) 的ED停留,与≤2小时 (P < 0.001) 相比,观察到更高的死亡风险.
- 与预期相反,更长的ED停留时间与较低的住院费用有关,≥48小时的住院费用减少了1,211美元 (P < 0.001).
结论:
- 长时间停留在急诊室 (ED) 与延长住院时间和死亡风险的增加有显著关联.
- 矛盾的是,尽管ED的资源消耗增加,但更长的ED停留时间与整体住院成本的降低有关.
- 实施缩短ED停留时间的策略对于改善患者的治疗结果和优化医疗保健资源配置至关重要.
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