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在城市基本生命支持系统中,医疗优先调度系统的性能指标
Vittorio Nicoletta1,2, Maxime Robitaille-Fortin3, Valérie Bélanger4
1Department of Logistics and Operations Management, HEC Montréal, 3000 Côte-Sainte-Catherine Road, Montreal, QC, H3T 2A7, Canada.
概括
北克的急救医疗服务 (EMS) 调度优先级显示出高过量选,这意味着发送了太多紧急电话,耗尽了资源. 最近的变化减少了不足的选,但加剧了过量选,突出了需要改进的出货标准的需要.
科学领域:
- 紧急医疗 紧急医疗
- 公共卫生系统 公共卫生系统
- 医疗保健资源管理 医疗保健资源管理
背景情况:
- 有效的紧急医疗服务 (EMS) 调度优先级对于资源分配和及时响应至关重要.
- 加拿大北克省使用了经过修改的医疗优先发送系统 (MPDS),具有区域优先定义.
- 这种适应的EMS调度系统的性能尚未得到正式评估.
研究的目的:
- 评估北克适应的EMS发货优先级系统的有效性.
- 为了比较接电话的优先级级与现场护理人员的评估.
- 为了分析系统在三年内和首席投诉中表现的演变.
主要方法:
- 北克省96,099件EMS发货的回顾性观察研究 (2021-2023年).
- 使用灵敏度,特异性,过量选,不足选,预测值和准确度进行性能评估.
- 统计分析包括千平方和t测试;主要投诉变化的检查.
主要成果:
- 观察到过度选率很高,79.7%的病例被护理人员认为是稳定/非紧急的,尽管最初的紧急发送.
- 对于腹痛,跌倒和精神问题,观察到高过量选率 (>90%).
- 过敏反应,糖尿病问题和心脏病显示出最高的不足率 (>10%).
- 在三年内对优先级的修改减少了2.5%的不足,但增加了3.7%的过量选 (p<0.05).
结论:
- 该系统有效地识别非紧急病例,但遭受了显著的过度选,影响了EMS资源.
- 最近的优先级调整加剧了过度选,使资源管理复杂化.
- 完善调度标准和探索AI决策支持可能会提高准确性和效率.
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