George Washington University, Department of Emergency Medicine, 2120 L Street NW Suite 450, Washington DC 20037, United States.
George Washington University, Department of Emergency Medicine, 2120 L Street NW Suite 450, Washington DC 20037, United States.
J Infect Public Health. 2019 Nov-Dec;12(6):794-798. doi: 10.1016/j.jiph.2019.04.001. Epub 2019 Apr 18.
Global health emergencies, such as from diseases like dengue fever, can lead to rapid surges in visits to emergency departments. The objective of our study was to evaluate the impact of dengue on factors that could impact emergency department flow, including patient volume and staffing, on Indian emergency departments.
This was a prospective cohort study of Indian emergency providers. Respondents were queried via online survey about a number of domains including practice environment, use of rapid testing, changes in ED volume and ED staffing adjustments occurring during dengue season. Data was analyzed using multivariate analysis.
We had a total of 210 respondents to our online survey. Less than half of respondents reported that their institutions used rapid point of care testing. When asked how dengue impacted ED flow, the most common response was that dengue increased the total number of ED visits (84%). Despite this increase, only about 32% of respondents reported that their institutions increased hospital staffing. In multivariate analysis, respondents at hospitals that experienced ED visit surges over 40% of baseline were more likely to also report that their institutions also increased staffing during this time (OR 3.28, 95% CI 1.44-7.46).
Our study shows that despite increases in visits during dengue season, ED providers noted that their EDs did not respond with staffing increases. More research is needed to better understand how emergency departments can adjust to dengue to provide optimal care for patients in India.
全球卫生紧急情况,如登革热等疾病,可能导致急诊科就诊人数迅速增加。我们的研究目的是评估登革热对影响急诊科流量的因素的影响,包括患者数量和人员配置,在印度急诊科。
这是一项对印度急诊科提供者的前瞻性队列研究。通过在线调查,受访者被询问了包括实践环境、快速检测使用、登革热季节期间急诊科就诊量和急诊科人员配置调整在内的多个领域。使用多变量分析对数据进行分析。
我们共有 210 名受访者参加了我们的在线调查。不到一半的受访者报告说他们的机构使用了即时护理点检测。当被问及登革热如何影响急诊科流量时,最常见的回答是登革热增加了急诊科就诊的总人数(84%)。尽管如此,只有约 32%的受访者报告说他们的机构增加了医院的人员配置。在多变量分析中,急诊科就诊量比基线增加 40%以上的医院的受访者更有可能报告说,他们的机构在这段时间也增加了人员配置(比值比 3.28,95%置信区间 1.44-7.46)。
我们的研究表明,尽管登革热期间就诊人数增加,但急诊科提供者指出,他们的急诊科没有增加人员配置。需要进一步研究以更好地了解急诊科如何应对登革热,为印度的患者提供最佳护理。