工作量和班次特征对紧急医疗住院人员诊断资源利用的影响
Sumeyye Cakmak1, Raif Kaan Bas2, Nihat Mujdat Hokenek1
1Department of Emergency Medicine, University of Health Sciences, Istanbul Cam and Sakura City Research and Training Hospital, Istanbul, Turkey.
International journal of general medicine
|December 24, 2025
概括
住院工作量,医生性别和资历都会对急诊室的诊断成本产生重大影响. 患者年龄和重复访问等因素也推动了支出,突出了成本意识的实践改进领域.
科学领域:
- 紧急医疗 紧急医疗
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
背景情况:
- 在急诊室 (ED) 的诊断费用占医疗保健成本的很大一部分.
- 了解影响这些成本的因素,特别是对于低急性患者来说,对于优化资源配置至关重要.
- 以前的研究还没有完全阐明居民特征和运营因素对诊断支出的综合影响.
研究的目的:
- 调查轮班特征,住院工作量和医生属性如何影响ED中低急性 (绿色分组) 患者的诊断支出.
- 确定这一患者群体中诊断成本的关键决定因素.
主要方法:
- 在一个月内,71名住院居民管理了22427次低急性ED访问的回顾性横截面分析.
- 提取了居民特征,患者人口统计和诊断支出 (实验室,成像,药物订单,总成本) 的数据.
- 统计分析包括非参数测试和Gamma通用线性模型来确定成本决定因素.
主要成果:
- 女性居民在实验室,成像和药物订单上承担了更高的费用.
- 中层居民的支出最高,而老年居民则表现出降低成本的效果.
- 增加住院工作量 (每日患者数量) 与总诊断成本相反相关.
- 患者的因素,如晚年和重复使用ED显著增加了成本.
- 重复的ED访问是最有力的成本决定因素,增加了三倍以上的支出.
结论:
- 在低急性ED遭遇的诊断支出受到临床和操作因素的影响.
- 居民工作量,年龄和性别是独立的成本影响因素.
- 患者年龄和之前的ED利用是支出的主要驱动因素,强调需要有针对性的成本意识的战略.
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