Redmond E J, Forde J C, Abdelrahman M A, Kelly N P, Akram C, Giri S K, Flood H D
Department of Urology, University Hospital Limerick, Dooradoyle, Limerick, Ireland,
Ir J Med Sci. 2015 Jun;184(2):493-7. doi: 10.1007/s11845-014-1154-8. Epub 2014 Jun 6.
Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period.
A prospective logbook was maintained for all urology referrals from the emergency department between August 2012 and March 2013. The diagnosis and patient outcome was recorded for each referral. The emergency theatre logbook was retrospectively evaluated for all emergency urology procedures carried out over the same time period. A basic cost analysis was performed to calculate the cost of providing the on-call service.
A total of 752 patients were referred to the urology service over a 12-month period. The most common reasons for referral were renal colic and scrotal pain. Approximately 41 % of referrals were discharged directly from the emergency department. There were 167 emergency operations performed in total. The majority of emergency operations and referrals from the emergency department took place outside of normal working hours. A basic cost analysis revealed an associated cost saving of €58,120.
Emergency urology activity constitutes a large proportion of the workload at our institution. Restricting emergency urology cover would limit essential training opportunities for urology trainees, increases length of stay and delay treatment of urological emergencies. Urology "out of hours" cover is a cost-efficient method of service provision.
在大多数教学医院，泌尿外科通常提供非工作时间的值班服务。然而，削减医院开支的压力不断增加，迫使许多机构考虑取消正常工作时间以外的中级职称值班服务。本研究的目的是审核我们机构在12个月期间的泌尿外科急诊活动。
对2012年8月至2013年3月期间急诊科所有泌尿外科转诊病例进行前瞻性记录。记录每个转诊病例的诊断和患者结局。回顾性评估同一时期内所有泌尿外科急诊手术的急诊手术记录。进行基本成本分析以计算提供值班服务的成本。
在12个月期间，共有752例患者被转诊至泌尿外科服务。转诊的最常见原因是肾绞痛和阴囊疼痛。约41%的转诊患者直接从急诊科出院。总共进行了167例急诊手术。大多数急诊手术和来自急诊科的转诊发生在正常工作时间之外。基本成本分析显示节省了58,120欧元的相关成本。
泌尿外科急诊活动在我们机构的工作量中占很大比例。限制泌尿外科急诊值班服务将限制泌尿外科实习生的基本培训机会，增加住院时间并延迟泌尿外科急诊的治疗。泌尿外科“非工作时间”值班服务是一种具有成本效益的服务提供方式。
