Dunn Robert
Emergency Department, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia.
Emerg Med (Fremantle). 2003 Jun;15(3):232-8. doi: 10.1046/j.1442-2026.2003.00441.x.
To study the effect of changes in hospital occupancy and ED occupancy on ED waiting times during a 13-day period of improved bed access.
A comparative, observational study of 1133 ED attendances in the study period and 2332 attendances in a historical control period.
During the study period, mean hospital occupancy decreased from 94.9% to 89.0% (P < 0.001), mean ED occupancy decreased from 19.1 to 14.8 patients (P < 0.001) and the mean ED waiting time decreased from 58.5 to 37.1 min (P < 0.001). There were statistically significant reductions in waiting times for patients in Australasian triage scale (ATS) categories 2-5. Departmental staffing levels, attendances and patient acuity were not significantly different during the study and control periods.
Modest decreases in hospital occupancy resulted in highly significant reductions in ED waiting times. Emergency department overcrowding due to large numbers of admitted patients awaiting hospital admission is a major cause of ED dysfunction.
研究在改善床位可及性的13天期间,医院住院率和急诊科(ED)使用率的变化对ED候诊时间的影响。
一项对比性观察研究,研究期间有1133例ED就诊患者,历史对照期有2332例就诊患者。
在研究期间,医院平均住院率从94.9%降至89.0%(P<0.001),ED平均使用率从19.1例患者降至14.8例患者(P<0.001),ED平均候诊时间从58.5分钟降至37.1分钟(P<0.001)。澳大利亚分诊量表(ATS)2-5类患者的候诊时间有统计学意义的缩短。研究期和对照期的科室人员配备水平、就诊人数和患者 acuity 无显著差异。
医院住院率的适度下降导致ED候诊时间大幅显著缩短。大量等待住院的患者导致急诊科过度拥挤是ED功能障碍的主要原因。