美国紧急诊所缺乏24/7临床医生覆盖,2022年
Carlos A Camargo1, Krislyn M Boggs1, Ashley F Sullivan1
1Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Journal of the American College of Emergency Physicians open
|February 24, 2025
概括
美国大约7.4%的急诊室 (ED) 缺乏24小时不间断的临床医生覆盖,特别是在农村,低人数的临床医院 (CAH). 这突显了紧急护理和劳动力分配的关键差距.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健劳动力研究 劳动力研究
- 农村卫生 农村卫生
背景情况:
- 在急诊室 (ED) 中,越来越多的人依赖非医生从业者.
- 担心美国EDs中医生的数量减少,特别是在农村地区.
- 需要评估美国ED的24/7医生覆盖范围的程度.
研究的目的:
- 为了确定美国ED的百分比缺乏24/7的临床医生覆盖.
- 调查EDs的地理分布和特征,而不需要医生持续存在.
- 为了确定与24 / 7临床医生覆盖率的缺失相关的因素.
主要方法:
- 利用了2022年国家ED清单 (NEDI) -美国调查数据.
- 接受调查的急救主任对24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时24小时.
- 分析了ED特征 (访问量,关键入口医院状态,农村位置) 和覆盖差距之间的关联.
主要成果:
- 响应的急救医院中有7.4% (344 out of 4621) 缺乏24/7的临床医生覆盖.
- 像北达科他州 (58%),南达科他州 (56%) 和蒙大拿州 (46%) 这样的州报告了高百分比的EDs没有连续的医生覆盖.
- 没有24 / 7覆盖的ED主要是低体积 (<10,000次访问/年) (92%),关键访问医院 (CAHs) (89%) 和农村 (72%).
结论:
- 大约13个美国急救中心中的1个没有24/7的临床医生覆盖.
- 缺乏持续的医生覆盖在低容量ED和CAH中更为普遍.
- 对CAH的监管变化可能为解决这些关键紧急护理工作人员缺口提供了一条途径.
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