紧急部门的观察单位是否有好处:叙述审查
Emmeline Leggett1, Shirin Haan2, Carolina Mendoza3
1School of Medicine, University of Maryland, Baltimore, MD 21201, USA.
Journal of clinical medicine
|June 26, 2025
概括
应急部门观察单位 (EDOU) 可以减少应急部门停留时间和住院费用. 然而,高的实施成本是一个障碍,需要进一步研究它们的好处和最佳使用.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 美国越来越多的急诊室 (ED) 访问导致拥挤,ED停留时间延长 (EDLOS),患者的治疗结果更差.
- 紧急部门观察单位 (EDOU) 越来越多地被用于减轻ED拥挤和改善患者流动.
- 目前关于EDOU实施的好处和障碍的文献需要进行全面评估.
研究的目的:
- 对现有关于紧急部门观察单位 (EDOU) 的文献进行叙事审查.
- 调查EDOU的好处,重点关注急诊室停留时间 (EDLOS),住院率和7天返回率.
- 确定EDOU的建立和有效实施的障碍.
主要方法:
- 一个PICO (患者干预控制结果) 框架指导了文献搜索.
- 从PubMed的成立到2024年11月14日,在PubMed上进行了搜索,包括随机试验和观察性研究.
- 符合条件的研究报告了EDOU前与EDOU后的数据,或将EDOU患者与对照组进行比较,重点关注EDLOS,入院率和7天返回率.
主要成果:
- 包括34篇文章,其中4篇报告EDLOS在14-23小时之间;一些研究显示EDLOS显著减少 (23-28%),而另一些则没有发现差异.
- 四项研究表明,住院率显著降低 (2.7%-44%),集中EDOU标准显示影响更大.
- 关于7天返回率的有限数据显示1.9%在72小时内返回,10.8%在14天内返回;许多返回是原来的首席投诉在48小时内出院.
结论:
- 紧急部门观察单位 (EDOU) 在减少EDLOS和住院患者方面展示了潜在的好处.
- 高的初始实施成本是EDOU建立的重要障碍.
- 需要进一步进行强有力的研究,以充分阐明EDOU的复杂性和优化EDOU的好处.
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