Adult Emergency Department, Auckland City Hospital, Auckland, New Zealand.
Emerg Med Australas. 2011 Oct;23(5):587-92. doi: 10.1111/j.1742-6723.2011.01451.x. Epub 2011 Jun 27.
To document the extent of access block and ED overcrowding in New Zealand in 2010 and to determine whether these were linked to the hospital's ability to meet the Shorter Stays in ED target.
Surveys of all New Zealand EDs were undertaken at two points in time in 2010 to determine ED occupancy. Data on target achievement during corresponding time periods were obtained from the Ministry of Health.
In tertiary and secondary hospitals, respectively, access block was seen in 64% versus 23% (P= 0.05) and overcrowding was seen in 57.1% versus 39% (P= 0.45). No hospital with access block met the 'Shorter Stays' target, compared with 60% without access block (P= 0.001). Twenty-three per cent of hospitals with ED overcrowding met the target compared with 43% without ED overcrowding (P= 0.42). The number of patients experiencing ≥8 h delay to admission were 25 in May and 59 in August (P= 0.04). This represented 45.5% and 79.7% of patients waiting for admission, respectively (P= 0.08).
Hospital access block was seen more often in larger hospitals and significantly associated with failure to meet the 'Shorter Stays in ED' health target, whereas ED overcrowding was seen in both small and large hospitals, but not associated with failure to meet the target.
记录 2010 年新西兰急诊室（ED）就诊受限和过度拥挤的程度，并确定这些现象是否与医院达到 ED 短留观目标的能力有关。
2010 年分两个时间点对所有新西兰 ED 进行调查，以确定 ED 入住率。同期的目标实现数据来自卫生部。
在三级和二级医院中，就诊受限分别为 64%和 23%（P=0.05），过度拥挤分别为 57.1%和 39%（P=0.45）。没有就诊受限的医院达到了“缩短 ED 留观时间”的目标，而就诊受限的医院中只有 60%达到了该目标（P=0.001）。23%的 ED 过度拥挤医院达到了目标，而 ED 不过度拥挤的医院中有 43%达到了目标（P=0.42）。在 5 月和 8 月，有≥8 小时延迟入院的患者人数分别为 25 人和 59 人（P=0.04）。这分别代表等待入院的患者的 45.5%和 79.7%（P=0.08）。
就诊受限在较大的医院中更为常见，且与未能达到“ED 短留观时间”的健康目标显著相关，而 ED 过度拥挤在大小医院中均有发生，但与未能达到目标无关。
