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加拿大内血管治疗接入的地理建模表明,需要降低门入门出门时间
Noreen Kamal1,2, Borna Baradaran-Noveiri1, Jack Barrie3
1Department of Industrial Engineering, https://ror.org/01e6qks80Dalhousie University, Halifax, NS, Canada.
概括
在加拿大改善对内血管治疗 (EVT) 的准入需要减少门入门出门 (DIDO) 时间. 有效的DIDO时间显著增加了中风患者的数量,这些患者可以在关键的3小时和6小时窗口内及时接受EVT.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 及时内血管治疗 (EVT) 对缺血性中风患者至关重要,但加拿大的地理位置带来了接入挑战.
- EVT集中在城市的三级医疗中心,需要从仅用于静脉血栓溶解 (IVT) 的设施转移.
研究的目的:
- 模拟在加拿大各地对EVT的地理接入.
- 评估门内门外 (DIDO) 时间对EVT可访问性的影响.
主要方法:
- 地理建模使用网格段来计算到中风中心的驱动时间.
- 综合人口数据,以在不同的DIDO时间下确定访问率 (45分钟最佳,150分钟低于最佳).
- 计算访问IVT (4.5小时) 和EVT (6小时和3小时).
主要成果:
- 99.37%的加拿大人可以在4.5小时内获得IVT.
- 低于最佳的DIDO时间使13.6% (6小时窗口) 和42.7% (3小时窗口) 没有EVT访问.
- 优化DIDO时间可使EVT访问额外提高5.6% (6小时) 和15.7% (3小时).
结论:
- 将DIDO时间缩短到平均45分钟对于公平的EVT访问至关重要.
- 有效的患者转移协议对于最大限度地提高加拿大EVT的好处至关重要.
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