Sorbonne Universités, UPMC Paris Univ-06, Paris, France.
Emergency Département, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France.
PLoS One. 2018 Jun 14;13(6):e0198474. doi: 10.1371/journal.pone.0198474. eCollection 2018.
Some major changes have occurred in emergency department (ED) organization since the early 2000s, such as the establishment of triage nurses and short-track systems. The objectives of this study were to describe the characteristics of French EDs organization and users, based on a nationwide cross-sectional survey.
The French Emergency Survey was a nationwide cross-sectional survey. All patients presenting to all EDs during a 24-hr period of June 2013 were included. Data collection concerned ED characteristics as well as patient characteristics.
Among the 736 EDs in France, 734 were surveyed. Triage nurses and short-track systems were respectively implemented in 73% and 41% of general EDs. The median proportion of patients aged > 75 years was 14% and median hospitalisation rate was 20%. During the study period, 48,711 patients presented to one of the 734 EDs surveyed. Among them, 7% reported having no supplementary health or universal coverage (for people with lower incomes). Overall, 50% of adult patients had been seen by the triage nurse in less than 5 minutes, 74% had a time to first medical contact shorter than one hour and 55% had an ED length of stay shorter than 3 hours.
The French Emergency Survey is the first study to provide data on almost all EDs in France. It underlines how ED organization has been redesigned to face the increase in the annual census. French EDs appear to have a particular role for vulnerable people: age-related vulnerability and socio-economic vulnerability with an over-representation of patients without complementary health coverage.
自 21 世纪初以来,急诊科(ED)的组织发生了一些重大变化,例如设立分诊护士和短道系统。本研究的目的是根据一项全国性的横断面调查,描述法国 ED 组织和使用者的特征。
法国急诊调查是一项全国性的横断面调查。所有在 2013 年 6 月 24 小时内就诊于所有 ED 的患者均被纳入研究。数据收集包括 ED 特征和患者特征。
法国共有 736 家 ED,其中 734 家参与了调查。分诊护士和短道系统分别在 73%和 41%的综合 ED 中实施。75 岁以上患者的中位数比例为 14%,住院率中位数为 20%。在研究期间,共有 48711 名患者到参与调查的 734 家 ED 之一就诊。其中,7%的患者报告没有补充健康保险或全民覆盖(针对收入较低的人群)。总体而言,50%的成年患者在 5 分钟内接受了分诊护士的评估,74%的患者首次医疗接触时间短于 1 小时,55%的患者 ED 停留时间短于 3 小时。
法国急诊调查是第一项提供法国几乎所有 ED 数据的研究。它强调了 ED 组织如何重新设计以应对年度普查的增加。法国 ED 似乎对弱势群体具有特殊作用:与年龄相关的脆弱性和社会经济脆弱性,表现为没有补充健康保险覆盖的患者比例过高。