Menec Verena H, Bruce Sharon, MacWilliam Leonard
Department of Community Health Sciences, University of Manitoba, 408-727 McDermot Avenue, Winnipeg, MB, R3E 3P5, Canada.
Can J Aging. 2005 Spring;24 Suppl 1:121-31. doi: 10.1353/cja.2005.0051.
Hospital overcrowding has plagued Winnipeg and other Canadian cities for years. This study explored factors related to overcrowding. Hospital files were used to examine patterns of hospital use from fiscal years 1996/1997 to 1999/2000. Chart reviews were conducted to examine appropriateness of admissions and hospital stays during one pressure week. Results indicate that pressure periods in the hospital system were driven by an influx of older adults with influenza-associated respiratory illnesses. Moreover, examination of one specific pressure week showed that at least 100 beds were occupied by patients who likely did not require acute care. The chart review revealed that a substantial proportion of non-acute patient-days were spent awaiting home care, long-term care, or diagnostic testing services. These findings suggest future bed pressures might be prevented through influenza vaccination and an increase in the availability of--and timely transfer to--alternative levels of care.
多年来，医院人满为患一直困扰着温尼伯及加拿大其他城市。本研究探讨了与人满为患相关的因素。利用医院档案研究了1996/1997财政年度至1999/2000财政年度的医院使用模式。在一个压力周期间进行图表审查，以检查入院和住院时间的合理性。结果表明，医院系统的压力期是由患流感相关呼吸道疾病的老年人涌入所驱动的。此外，对一个特定压力周的检查显示，至少有100张床位被可能不需要急症护理的患者占用。图表审查显示，相当一部分非急症患者住院日是在等待家庭护理、长期护理或诊断检测服务。这些发现表明，通过流感疫苗接种以及增加替代护理级别服务的可及性并及时将患者转至这些服务，可以预防未来的床位压力。
