全州范围的转移协调和患者转移率在医院之间在职位压力期间
Mary E Richert1,2, Guoqing Diao1,2,3, Alex Mancera1,2
1Critical Care Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland.
JAMA network open
|December 1, 2025
概括
国家医疗行动协调中心 (SMOCCs) 最初在流行病激增期间将医院转移增加了35%. 这些中心可以在公共卫生紧急情况下改善获得护理的机会,但它们的常规实用性需要进一步研究.
科学领域:
- 公共卫生 公共卫生
- 医疗系统管理 医疗系统管理
- 紧急医疗 紧急医疗
背景情况:
- 美国各州在COVID-19大流行期间建立了州医疗行动协调中心 (SMOCC).
- SMOCC的目的是协调患者转移,并在医院床位容量有限的情况下优化护理提供.
- 了解SMOCC的影响对于它们在未来公共卫生紧急情况中的潜在作用至关重要.
研究的目的:
- 调查大流行期间SMOCC和成人医院间转移 (IHT) 的建立之间的联系.
- 评估SMOCC对医疗保健系统压力和患者获得护理的影响.
主要方法:
- 一项中断时间序列队列研究分析了美国8个州住院成年人 (≥18岁) 的数据.
- 数据范围从2020年6月1日到2022年12月30日,重点关注紧急医疗服务 (EMS) 的医院间转移.
- 医院占用压力是使用每日人口普查和人员床位数量来衡量医院占用压力的压力,以评估SMOCC在不同压力水平下的影响.
主要成果:
- SMOCC的建立与IHT费率最初增加35% (RR, 1.35) 相关,随后持续下降 (RR, 0.94).
- 在SMOCC实施后,在高占用压力时期观察到转移的显著增加 (RR, 1.23).
- 通过城市化,运输方式,患者年龄和敏度分层的分析,研究结果保持一致.
结论:
- 疫情引发的SMOCC显示转移量立即上升,这可能是为了应对激增期间需求的增加.
- 在大规模的公共卫生危机期间,SMOCCs可以提高护理准入,并缓解转移瓶.
- 需要进一步的研究来确定SMOCC在非紧急时期的有效性.
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