Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
Emerg Med Australas. 2019 Dec;31(6):1014-1023. doi: 10.1111/1742-6723.13301. Epub 2019 May 6.
To describe and compare characteristics and outcomes of patient presentations brought in by police (BIBP) with those not BIBP (NBIBP) to one Australian ED.
A retrospective observational study. All patient presentations to a tertiary hospital ED made during the period 8 October 2012 to 7 April 2013 were included. Routinely collected ED information data and medical record review data were used. ED care delivery for people BIBP from the watch house (WH) or other location was compared. Univariate comparison and multivariate logistic regression analyses were performed to identify the different characteristics and ED outcomes between BIBP and NBIBP groups.
A total of 35 127 ED presentations occurred within the 6 month period; 392 (1.1%) were BIBP. Compared with those NBIBP, those BIBP were diagnosed with 'psychiatric' and 'toxicology-related' illnesses in higher proportions. Overlap in health conditions (primarily for physical health reasons) between those BIBP and NBIBP existed. Presentations BIBP from the WH reflected 'physical health emergencies' whereas presentations BIBP from other locations reflected 'behavioural emergencies'. Compared to those NBIBP, those BIBP had a longer wait to be seen (by about 5 min), longer ED length of stay (LOS) if not admitted (by about 20 min) but shorter ED LOS if admitted (by about 59 min). When adjusted for sex, age group and diagnosis, ED LOS (if admitted) and admission rate were statistically significant. For those BIBP, mental health related orders and alcohol breath tests were common.
Patients BIBP were different to those NBIBP. Despite comprising a small proportion of overall ED attendances, they are a group where mental health and drug and alcohol issues are over-represented. Differences in ED care delivery for those BIBP highlights potential opportunities for pre-hospital healthcare interventions.
描述并比较带入澳大利亚急诊部(ED)的警察带入患者(BIBP)与非警察带入患者(NBIBP)的特征和结局。
本研究采用回顾性观察性研究设计。纳入 2012 年 10 月 8 日至 2013 年 4 月 7 日期间在一家三级医院 ED 就诊的所有患者。使用常规收集的 ED 信息数据和病历回顾数据。比较从看守所(WH)或其他地点带入 ED 的 BIBP 与 NBIBP 人群的 ED 治疗情况。采用单变量比较和多变量逻辑回归分析来确定 BIBP 与 NBIBP 组之间的不同特征和 ED 结局。
在 6 个月期间,共有 35127 例 ED 就诊,其中 392 例(1.1%)为 BIBP。与 NBIBP 相比,BIBP 更可能被诊断为“精神科”和“毒理学相关”疾病。BIBP 与 NBIBP 之间存在健康状况重叠(主要是出于身体健康原因)。从 WH 带入的 BIBP 反映出“身体健康紧急情况”,而从其他地点带入的 BIBP 则反映出“行为紧急情况”。与 NBIBP 相比,BIBP 等待就诊的时间更长(约 5 分钟),如果未入院,ED 停留时间(LOS)更长(约 20 分钟),但如果入院,ED LOS 更短(约 59 分钟)。在调整性别、年龄组和诊断后,ED LOS(如果入院)和入院率具有统计学意义。对于 BIBP,心理健康相关医嘱和酒精呼气测试很常见。
BIBP 患者与 NBIBP 患者不同。尽管 BIBP 仅占 ED 就诊总人数的一小部分,但他们是精神健康和药物及酒精问题发生率过高的人群。对 BIBP 进行不同的 ED 治疗提供了院前医疗干预的潜在机会。