哥伦比亚波哥大的急诊科特点与能力

Emergency department characteristics and capabilities in Bogotá, Colombia.

作者信息

Bustos Yury, Castro Jenny, Wen Leana S, Sullivan Ashley F, Chen Dinah K, Camargo Carlos A

机构信息

Department of Emergency Medicine, Universidad del Rosario, Carrera 24 N° 63C-69, Bogotá, Colombia,

出版信息

Int J Emerg Med. 2015 Dec;8(1):79. doi: 10.1186/s12245-015-0079-y. Epub 2015 Aug 8.

DOI:10.1186/s12245-015-0079-y

PMID:26253755

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4529430/

Abstract

BACKGROUND

Emergency departments (EDs) are a critical, yet heterogeneous, part of international emergency care. The National ED Inventories (NEDI) survey has been used in multiple countries as a standardized method to benchmark ED characteristics. We sought to describe the characteristics, resources, capabilities, and capacity of EDs in the densely populated capital city of Bogotá, Colombia.

METHODS

Bogotá EDs accessible to the general public 24/7 were surveyed using the 23-item NEDI survey used in several other countries ( www.emnet-nedi.org ). ED staff were asked about ED characteristics with reference to calendar year 2011.

RESULTS

Seventy EDs participated (82 % response). Most EDs (87 %) were located in hospitals, and 83 % were independent hospital departments. The median annual ED visit volume was approximately 50,000 visits. Approximately 90 % (95 % confidence interval (CI) 80-96 %) had a contiguous layout, with medical and surgical care provided in one area. Almost all EDs saw both adults and children (91 %), while 6 % saw only adults and 3 % saw only children. Availability of technological and consultant resources in EDs was variable. Nearly every ED had cardiac monitoring (99 %, 95 % CI 92-100 %), but less than half had a dedicated CT scanner (39 %, 95 % CI 28-52 %). While most EDs were able to treat trauma 24/7 (81 %, 95 % CI 69-89 %), few could manage oncological (22 %, 95 % CI 13-34 %) or dental (3 %, 95 % CI 0-11 %) emergencies 24/7. The typical ED length-of-stay was between 1 and 6 h in 59 % of EDs (95 % CI, 46-70 %), while most others reported that patients remained for >6 h (39 %). Almost half of respondents (46 %, 95 % CI 34-59 %) reported their ED was over capacity.

CONCLUSIONS

Bogotá EDs have high annual visit volumes and long length-of-stay, and half are over capacity. To meet the emergency care needs of people in Bogotá and other large cities, Colombia should consider improving urban ED capacity and training more emergency medicine specialists capable of efficiently staffing its large and crowded EDs.

摘要

背景

急诊科是国际急诊护理中关键但异质性的一部分。国家急诊科清单（NEDI）调查已在多个国家用作衡量急诊科特征的标准化方法。我们试图描述哥伦比亚人口密集的首都波哥大急诊科的特征、资源、能力和容量。

方法

使用其他几个国家采用的包含23个项目的NEDI调查问卷（www.emnet - nedi.org）对波哥大每周7天、每天24小时向公众开放的急诊科进行调查。急诊科工作人员被问及2011年日历年的急诊科特征。

结果

70家急诊科参与调查（回复率82%）。大多数急诊科（87%）位于医院内，83%是独立的医院科室。急诊科年就诊量中位数约为50000人次。约90%（95%置信区间（CI）80 - 96%）布局连贯，医疗和外科护理在一个区域提供。几乎所有急诊科都诊治成人和儿童（91%），6%只诊治成人，3%只诊治儿童。急诊科技术和会诊资源的可获得性各不相同。几乎每个急诊科都有心脏监测设备（99%，95%CI 92 - 100%），但不到一半有专用CT扫描仪（39%，95%CI 28 - 52%）。虽然大多数急诊科能够每周7天、每天24小时治疗创伤（81%，95%CI 69 - 89%），但很少有急诊科能每周7天、每天24小时处理肿瘤急症（22%，95%CI 13 - 34%）或牙科急症（3%，95%CI 0 - 11%）。59%的急诊科典型留观时间在1至6小时之间（95%CI，46 - 70%），而大多数其他急诊科报告患者留观时间超过6小时（39%）。近一半的受访者（46%，95%CI 34 - 59%）报告他们的急诊科超容量。