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评估患者流中心对重症监护室患者出院和患者结果的有效性:一项追溯的定量队列研究

Xia Jin¹, Shailesh Bihari², Steven Galluccio³

¹Intensive Care Unit, Flinders Medical Centre, Adelaide, South Australia, Australia; Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia; College of Nursing and Health Sciences, Flinders University, South Australia, Australia.

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

|December 19, 2025

概括

集中式患者流中心 (PFC) 增加了重症监护室 (ICU) 退院延误,但减少了医院死亡率和住院时间. 这些中心提高了整体医院的效率和患者的治疗结果.

科学领域:

医疗保健管理的管理
密集护理医学密集护理医学
医院运营医院运营

背景情况:

集中式患者流中心 (PFC) 正在出现,以优化医院运营和资源利用.
PFCs对重症监护室 (ICU) 患者流动和结果的影响仍未得到充分研究.

研究的目的:

评估PFC对ICU出院效率和患者治疗结果的影响.
为了比较ICU出院指标和PFC实施前后的患者结果.

主要方法:

在澳大利亚接受第三级ICU治疗的8383名患者进行了回顾性队列研究 (2018-2023).
来自澳大利亚和新西兰重症监护协会成年患者数据库的数据.
主要结果:ICU退院延迟,工作时间后退院,48小时ICU再入院. 二次结果:集中治疗室/住院时间 (LOS),住院死亡率.

主要成果:

PFC的实施与急症监护室出院延迟 (16.1%) 和下班后出院 (15.6%) 的增加相关.
没有观察到48小时ICU再入院率的显著变化.
PFC组显示出更高的休息后出院风险 (OR1.62),但较低的医院死亡率 (OR0.72) 和较短的医院LOS (p=0.05).

结论:

PFC的实施导致了更多的ICU退院延误和超时退院,但没有增加ICU再接收.
通过PFC的集中协调可以改善医院的LOS并降低死亡率.
需要进一步的研究来探索PFC对ICU流量和访问封锁措施的有效性.

关键词:

在工作时间后放电.放电延迟的时间医院死亡率医院死亡率在重症监护病房的重症监护病房.逗留时间逗留时间患者流中心患者流中心再接纳是指重新接纳的人.

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