紧急诊所出勤率的变化模式:时间序列分析
Ahmad Alkhatib1, Paul Aylin2, Robert Klaber3
1Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK a.alkhatib@imperial.ac.uk.
Emergency medicine journal : EMJ
|December 4, 2025
概括
疫情后,急诊室 (ED) 的出勤率稳定下来,但老年人和患有复杂疾病的人数上升. 这凸显了对紧急护理服务的需求日益增加.
科学领域:
- 公共卫生 公共卫生
- 医疗保健管理的管理
- 流行病学 流行病学
背景情况:
- 需求的增加和有限的初级保健能力使急诊室 (EDs) 面临压力.
- 随着COVID-19大流行,医疗保健服务发生了重塑,加剧了现有的压力.
- 患者病例复杂性的增加是一个关键的,经常被忽视的,影响EDs的因素.
研究的目的:
- 评估2017年2月至2023年9月在伦敦西北部 (NWL) 的急诊室 (ED) 出勤率趋势.
- 分析流行前,流行期间和流行后的ED出勤模式.
- 检查社会人口统计学因素和多重疾病概况的趋势.
主要方法:
- 利用全系统综合护理 (WSIC) 数据仓库为NWL人口数据.
- 员工分段时间序列准波松回归用于每周ED出勤分析.
- 按年龄,性别,多重贫困指数和多重疾病状况分层模型.
主要成果:
- 在疫情前,ED总人数的年增长率为3.4%,这一数字显著增长.
- 总体而言,急救人员的出席率在流行病后稳定 (RR 1.002),但在老年人群中 (61-75,76+) 增加.
- 患有多重疾病和复杂多重疾病的患者的诊断增加了,而最不需要的患者的诊断减少了.
结论:
- 疫情后,ED总人数稳定下来,但趋势显示老年人使用率增加,特别是那些有复杂护理需求的人.
- 这些变化对医院容量产生重大影响,并对紧急和紧急护理系统造成压力.
- 建议进行进一步的研究,以调查这些不断变化的ED出勤模式背后的具体驱动因素.
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