Faculty of Health Sciences, La Trobe University, Melbourne, Australia.
Arch Phys Med Rehabil. 2012 Mar;93(3):441-5. doi: 10.1016/j.apmr.2011.09.021. Epub 2012 Jan 14.
To investigate how the allocation of referrals for a community rehabilitation service to triage categories affects waiting time from referral to first appointment, and whether other factors also contribute to variance in waiting time.
A prospective cohort study.
A multidisciplinary outpatient community rehabilitation program within a large metropolitan health service.
Consecutive adult patients (N=379) commencing rehabilitation over a 3-month period.
Allocation of referrals to a triage category of 1 (most urgent) to 4 (least urgent) by allied health clinicians guided by a written protocol.
The primary outcome was waiting time from referral to service commencement.
The small group of patients (4%) allocated to the most urgent category had significantly shorter mean waiting times than the other 3 categories (mean, 4.8d vs 19.6, 26.6, and 19.4d for categories 2, 3, and 4, respectively). Regression analysis indicated that approximately 11% of the variance in waiting time was accounted for by the triage categories. Site of treatment (home or center) and diagnosis also made small contributions (4% combined) to variance in waiting time.
The triage process ensured rapid service for a small number of urgent referrals, but made little difference to the waiting time of the vast majority of patients. Given the resources required for triaging patients, the results of this study lead us to question the value of the triage system in this setting.
调查将社区康复服务的转诊分配到分诊类别如何影响从转诊到首次预约的等待时间，以及其他因素是否也对等待时间的差异有影响。
前瞻性队列研究。
一个大型大都市卫生服务机构内的多学科门诊社区康复计划。
在 3 个月期间开始康复的连续成年患者（N=379）。
由联合健康临床医生根据书面方案将转诊分配到 1（最紧急）到 4（最不紧急）的分诊类别。
主要结局是从转诊到服务开始的等待时间。
被分配到最紧急类别的小患者群体（4%）的平均等待时间明显短于其他 3 个类别（分别为 4.8d、19.6d、26.6d 和 19.4d）。回归分析表明，分诊类别解释了约 11%的等待时间差异。治疗地点（家庭或中心）和诊断也对等待时间的差异有微小贡献（合计 4%）。
分诊过程确保了少数紧急转诊患者的快速服务，但对绝大多数患者的等待时间影响不大。考虑到分诊患者所需的资源，本研究的结果使我们对这种情况下分诊系统的价值产生了质疑。
