非医生提供者和医生提供的紧急护理趋势:2009-2021年
Summer Ghaith1, Cameron Gettel2,3, Megan McElhinny4
1Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA.
概括
现在,非医生提供者 (NPP) 管理了更多的急诊室 (ED) 访问,包括紧急病例. 紧急医疗 (EM) 护理模式的这种转变在所有地区都能观察到,特别是在农村地区.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健工作人员分析
- 医疗保健服务研究 医疗服务研究
背景情况:
- 非医生提供者 (NPPs),如医生助理和执业护士,在急诊室 (ED) 护理中发挥着越来越重要的作用.
- 了解不同类型的提供者对ED患者管理的不断变化的格局对于医疗保健规划和资源配置至关重要.
研究的目的:
- 描述非医生提供者 (NPP) 和紧急医疗 (EM) 医生管理的ED访问类型.
- 评估ED护理模式和提供者利用时间的变化 (2009-2021年).
主要方法:
- 利用了国家医院门诊医疗调查 (2009-2021) 的数据.
- 按提供者类型分类ED访问:仅限医生,与住院医生,与NPP医生,仅限NPP医生.
- 分析了访问特征 (人口统计,紧迫性,成像,停留时间,处置) 和使用Poisson回归的趋势.
主要成果:
- 只有医生的访问从77%下降到62%,而只有NPP的访问在2009年至2021年间从6%增加到11%.
- 核电站管理了越来越多的患者,包括那些有新兴分拣水平的患者,并在大都会和非大都会地区.
- 只有医生看的患者通常年龄较大,有更紧迫的需求,逗留时间较长,入院率较高,与仅由NPP看的患者相比.
结论:
- 紧急医疗工作人员经历了显著的转变,NPP管理越来越多的ED访问.
- 这一趋势包括通过NPPs来管理低急性和高急性患者.
- 这种转变在农村地区尤为明显,但在所有地区都是普遍的现象.
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