转移与医疗服务不足的急诊室的直接访问患者:一项回顾性队列研究
Kyongmin Sun1,2, Youjin Lee1, Jungsil Lee3
1Department of Emergency Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
BMC emergency medicine
|December 1, 2025
概括
被转移到服务不足地区的第三级急诊室的患者年龄较大,病情较重,使用更多资源. 他们较低的死亡率可能是由于分拣和生存偏见,不一定是更好的护理.
科学领域:
- 医疗保健管理的管理
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
背景情况:
- 优化医疗保健系统需要了解医疗服务不足地区的患者转移模式.
- 本研究探讨了在这样一个地区的第三级急诊室转移和直接访问患者之间的差异.
研究的目的:
- 为了比较人口统计,临床特征,资源利用和转移与直接访问患者的结果.
- 确定与转移患者临床结果相关的因素.
主要方法:
- 在韩国第三级医院ED (2023年1月至12月) 接受35,254名成年患者的回顾性队列研究.
- 患者分为转移 (n=7,069) 或直接访问 (n=28,185) 组.
- 后勤回归分析了与结果相关的因素;灵敏度分析排除了非医院心脏骤停患者.
主要成果:
- 转移的患者年龄较大,男性多,并呈现出更高的敏度 (KTAS 1-3: 87.5%).
- 转移患者的资源利用率更高:住院 (55.1%),ICU入院 (6.1%).
- 转移的患者在医院死亡率较低 (0.47%对0.75%),但在排除出院心脏骤停病例后,这种情况变得无关紧要.
结论:
- 转移的患者在服务不足的地区表现出更高的敏度和资源需求.
- 转移患者的较低死亡率可能反映了分组有效性和生存偏差.
- 调查结果强调了设施间传输网络和区域医疗保健中的选择效应的重要性.
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