Giunta Diego Hernán, Pedretti Ana Soledad, Elizondo Cristina María, Grande Ratti María Florencia, González Bernaldo de Quiros Fernán, Waisman Gabriel Darío, Peroni Hector José, Martínez Bernardo
Área de Investigación en Medicina Interna, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina,
Central de Emergencias de Adultos, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.
Rev Med Chil. 2017 May;145(5):557-563. doi: 10.4067/S0034-98872017000500001.
Crowding in Emergency Departments (ED), results from the imbalance between the simultaneous demand for health care and the ability of the system to respond. The NEDOCS scale (National Emergency Department Crowding Scale) measures the degree of crowding in an ED.
To describe ED Crowding characteristics, using the NEDOCS scale, in an Argentinean hospital.
A retrospective cohort study was conducted with all adult patient consultations between July 2013 and July 2014 at the ED of Hospital Italiano de Buenos Aires. We included all hours in the analysis period (365 days x 24 h = 8,760). The NEDOCS value was calculated for each hour using an automatic algorithm and was quantified in a six points score. Levels 4 (overcrowded), 5 (severely overcrowded) and 6 (dangerously overcrowded) were defined as overcrowding. Contour plots analysis was applied to identify patterns.
During the study period, 124,758 visits to the ED were registered. Overcrowding was present in 57.7% (5,055) of the analyzed hours. A predominance of scores between four and five was observed between 10:00 and 24:00 hours. The months with predominance of overcrowding were June, July and August (southern winter).
The calculation of the NEDOCS score and the analysis of its temporal distribution are highly relevant to identify opportunities for improvement and to develop mechanisms to prevent the highest categories of overcrowding.
急诊科拥挤是医疗保健的同时需求与系统响应能力之间失衡的结果。NEDOCS量表（国家急诊科拥挤量表）用于衡量急诊科的拥挤程度。
使用NEDOCS量表描述阿根廷一家医院急诊科的拥挤特征。
对2013年7月至2014年7月期间布宜诺斯艾利斯意大利医院急诊科的所有成年患者会诊进行回顾性队列研究。我们将分析期内的所有小时数（365天×24小时 = 8760小时）纳入分析。使用自动算法计算每个小时的NEDOCS值，并将其量化为六点分数。将4级（过度拥挤）、5级（严重过度拥挤）和6级（危险过度拥挤）定义为过度拥挤。应用等高线图分析来识别模式。
在研究期间，急诊科共登记了124,758次就诊。在分析的小时数中，57.7%（5055小时）存在过度拥挤。在10:00至24:00之间观察到四到五级分数占主导。过度拥挤占主导的月份是6月、7月和8月（南半球冬季）。
计算NEDOCS分数及其时间分布分析对于识别改进机会和制定预防最高级别的过度拥挤的机制高度相关。
