患者体积要求:2025年ACGME紧急医疗住院计划提案的评估
Carlisle E W Topping1, Craig Rothenberg2, Cameron J Gettel2
1Yale School of Medicine New Haven Connecticut USA.
AEM education and training
|June 27, 2025
概括
大多数紧急医疗 (EM) 住院项目都超过了拟议的3000名患者体积门. 将课程延长到4年可能不会显著增加临床暴露,正如研究生医学教育认证委员会 (ACGME) 的预期.
科学领域:
- 医学教育 医学教育
- 紧急医疗 紧急医疗
背景情况:
- 研究生医学教育认证委员会 (ACGME) 建议所有紧急医疗 (EM) 住院课程的长度为4年,每位住院员至少需要3000名患者.
- 根据这些拟议的要求,目前的EM住院计划每位住院医生的患者数量需要进行表征.
研究的目的:
- 分析目前每位EM住院计划的患者数量与拟议的ACGME要求相比.
- 确定满足拟议患者体积值的程序的数量.
- 为了估计4年计划长度授权对患者体积要求的影响.
主要方法:
- 一项横截面分析使用了2023年美国医院协会年度调查和2025年ACGME EM计划信息的链接数据.
- 医院邮政编码与农村-城市通勤区编码相匹配,以评估程序位置特征.
- 计算估计了每位住院居民的患者数量以及如果3年计划转换为4年计划的潜在变化.
主要成果:
- 在286个项目中,该计划的中位患者人数为7300人 (IQR:5190-10,207),明显超过了3000名患者的门.
- 97%的计划达到建议的患者体积值,在3年 (中位数7616) 和4年 (中位数6520) 计划中观察到类似的体积.
- 只有9个项目 (3%) 低于3000名患者的门;将这些3年计划延长到4年可能会使6个项目超过门.
结论:
- 目前,大多数EM住院项目都达到或超过了拟议的3000名患者数量要求.
- 将3年计划过渡到4年可能有助于大多数计划达到体积值,但可能不会显著增加最低临床暴露.
- 拟议的ACGME变更需要重新审查,以确保它们有效地增加了EM患者所需的临床暴露.
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