Moloney E D, Smith D, Bennett K, O'riordan D, Silke B
Division of Internal Medicine St. James' Hospital, Trinity College Dublin, James' Street, Dublin 8, Ireland.
QJM. 2005 Apr;98(4):283-9. doi: 10.1093/qjmed/hci044. Epub 2005 Mar 10.
While many UK hospitals have introduced an acute medical admissions unit (AMAU) to facilitate an efficient emergency admission process and reduce length of hospital stay (LOS), there is a lack of such data in the Republic of Ireland.
To determine the impact of an AMAU on emergency department (ED) wait times for a hospital bed, consultant practice, and LOS.
Retrospective analysis of data recorded in the hospital in-patient enquiry (HIPE) system.
We studied all emergency medical patients admitted to St James' Hospital Dublin between 1 January 2002 and 31 December 2003. In 2002, patients were admitted directly to a variety of wards, many of which were not affiliated with a medical specialty, under the care of a named consultant physician. In 2003, two centrally located wards were re-configured to function as an AMAU, and all emergency patients were admitted to this unit.
For all physician teams, median LOS shortened significantly from 2002 to 2003 (6 vs. 5 days, p<0.0001). Overall, patients seen by general physicians had a shorter LOS (5 days) than that of those seen by sub-specialists (6 days) (p<0.0001). The number of patients waiting in the ED for a hospital bed was reduced by 30% from 2002 to 2003 (p<0.001). Extrapolated cost savings for the hospital with the introduction of the AMAU were estimated at approximately 4039 bed-days and 1 714 152.
Introduction of the AMAU speeded access to acute medical service and reduced costs.
尽管许多英国医院已设立急性医疗收治单元（AMAU）以促进高效的急诊收治流程并缩短住院时间（LOS），但爱尔兰共和国缺乏此类数据。
确定AMAU对急诊部门（ED）等待病床时间、顾问医生诊疗及住院时间的影响。
对医院住院患者查询（HIPE）系统中记录的数据进行回顾性分析。
我们研究了2002年1月1日至2003年12月31日期间入住都柏林圣詹姆斯医院的所有急诊内科患者。2002年，患者直接入住各种病房，其中许多病房与医学专科无关，由指定的顾问医生负责照料。2003年，两个位于中心位置的病房重新配置为AMAU，所有急诊患者均入住该单元。
对于所有医生团队，住院时间中位数从2002年到2003年显著缩短（6天对5天，p<0.0001）。总体而言，普通内科医生诊治的患者住院时间（5天）比专科医生诊治的患者（6天）短（p<0.0001）。从2002年到2003年，在急诊部门等待病床的患者数量减少了30%（p<0.001）。引入AMAU后，医院估计节省的费用约为4039个床日和1714152。
引入AMAU加快了急性医疗服务的获取并降低了成本。
