对于避免入院的高急性第二天诊所的评估:一个为期13个月的队列研究
medRxiv : the preprint server for health sciences
|February 6, 2026
概括
一个新的下一天诊所 (NDC) 为急性疾病急诊室 (ED) 患者提供了住院的安全和可行的替代方案. 这种创新模式改善了患者的治疗结果,减少了医院再入院,并节省了大量的医疗保健费用.
科学领域:
- 医疗保健管理的管理
- 急性护理交付急性护理的交付
- 门诊服务 门诊服务
背景情况:
- 医院容量限制和医疗保健成本上升需要创新的急性护理模式.
- 现有的医院替代模型在可扩展性和长期可行性方面面临挑战.
研究的目的:
- 评估高急性次日诊所 (NDC) 的可行性和安全性,作为选择急性疾病急诊部 (ED) 患者住院的替代方案.
主要方法:
- 一项回顾性匹配队列研究比较了转诊到NDC的患者与历史ED对照.
- 匹配标准包括年龄,性别,疾病严重程度和初级诊断.
- 测量结果是活着和出院的几天 (DAOH),ED复诊,医院再入院和死亡率.
主要成果:
- 与对照组相比,NDC队列的DAOH平均增加了3.85个 (p<0.001).
- 据估计,NDC策略节省了358-1294个医院病床日.
- 患有NDC患者的30天再入院率 (5.7% vs 11.0%) 和死亡率 (0% vs 0.9%) 较低,但ED复诊率较高 (20.5% vs 13.0%).
结论:
- 对于特定急性ED患者来说,NDC是一种可行的,安全的住院替代方案.
- 这种模式对管理ED和医院容量有希望,同时降低医疗保健支出.
- 高急症门诊可以有效地替代住院治疗,减轻医院资源的压力.
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