一项新的急诊医学住院医师培训项目对社区医院急诊科患者住院时间的影响。

The effect of a new emergency medicine residency program on patient length of stay in a community hospital emergency department.

作者信息

Lammers Richard L, Roiger Michelle, Rice Laura, Overton David T, Cucos Diana

机构信息

Department of Emergency Medicine, Michigan State University Kalamazoo Center for Medical Studies, Kalamazoo, MI 49008, USA.

出版信息

Acad Emerg Med. 2003 Jul;10(7):725-30. doi: 10.1111/j.1553-2712.2003.tb00066.x.

DOI:10.1111/j.1553-2712.2003.tb00066.x

PMID:12837646

Abstract

OBJECTIVES

It is not clear how emergency medicine residents affect emergency department (ED) efficiency. The objective of this study was to determine whether a new emergency medicine residency program affected the length of stay (LOS) of patients in a community hospital ED.

METHODS

A before-and-after observational study was conducted during a one-year period prior to, and for three years after, the start of a new residency. An additional year's worth of data were collected during the fifth year after the residency started. Patients were excluded if their LOS was less than 30 minutes and they were admitted directly to the hospital. Explanatory variables included scheduled resident and student hours/day; scheduled faculty hours/day; nursing plus clerk hours/day; patients/day; ambulances/day; and admissions/day. The data were analyzed using descriptive and correlation statistics and regression analysis.

RESULTS

Average patient LOS prior to the residency was 122.9 minutes. During the first year of residency, it was 126.6 minutes; second year, 129.9 minutes; third year, 158.9 minutes; and fifth year, 162.4 minutes. There was a positive correlation between LOS and third-postgraduate-year resident (PGY-3) hours (rho = 0.43), and between LOS and PGY-3 hours/patients/day (rho = 0.42). All other correlations were poor (rho < 0.4).

CONCLUSIONS

In this ED, there was a weak, positive correlation between ED patient length of stay and the presence of PGY-3 emergency medicine residents.

摘要

目的

急诊医学住院医师如何影响急诊科（ED）的效率尚不清楚。本研究的目的是确定一项新的急诊医学住院医师培训计划是否会影响社区医院急诊科患者的住院时间（LOS）。

方法

在新住院医师培训开始前的一年期间以及开始后的三年期间进行了一项前后观察性研究。在住院医师培训开始后的第五年收集了额外一年的数据。如果患者的住院时间少于30分钟且直接入院，则将其排除。解释变量包括住院医师和学生的每日排班时长；教员的每日排班时长；护士加办事员的每日排班时长；每日患者数量；每日救护车数量；以及每日入院人数。使用描述性统计、相关性统计和回归分析对数据进行分析。

结果

住院医师培训前患者的平均住院时间为122.9分钟。住院医师培训第一年为126.6分钟；第二年为129.9分钟；第三年为158.9分钟；第五年为162.4分钟。住院时间与三年级住院医师（PGY - 3）的工作时长之间存在正相关（rho = 0.43），并且住院时间与PGY - 3的工作时长/每日患者数量之间也存在正相关（rho = 0.42）。所有其他相关性均较弱（rho < 0.4）。