Department of Trauma Rescue Center, Peking University People's Hospital, Beijing 100044, China.
Department of Trauma and Orthopaedics, Peking University People's Hospital, Beijing 100044, China.
Chin Med J (Engl). 2020 Jun 5;133(11):1268-1275. doi: 10.1097/CM9.0000000000000770.
We aimed to describe and analyze the pre-hospital emergency medical service (EMS) in Beijing and provide information for the government and medical institutions to optimize EMS.
We collected all pre-hospital emergency data in Beijing from 2008 to 2017. The chief complaint in each case was classified according to the Medical Priority Dispatch System (MPDS). The sites' administrative districts were determined through geo-encoding of addresses and then classified into four functional regions. We analyzed the demand for EMS, emergency response times (ERT), and disease spectrum for Beijing as a whole, and for each functional region.
A total of 4,192,870 pre-hospital EMS cases met the inclusion criteria, with a significant increase (P < 0.001) of 51.60% from 2008 to 2017. EMS demand was positively associated with population (r = 0.946, P < 0.001). The pre-hospital EMS demand rate was 1907.05 in 2008 and 2172.23 in 2017 per 100,000, with no significant change (P = 0.57). ERT increased significantly (P = 0.001), from 19.18 min in 2008 to 24.51 min in 2016. According to MPDS classifications, the demand for pre-hospital care increased for 14 diseases, remained stable for 19, and decreased for only 1 disease. Cases of injury-related disease increased significantly from approximately 90,000 in 2017, accounting for 20% of all pre-hospital EMS cases, and the demand rate decreased in the core region but increased in the sub-urban regions. Cases of heart problems and stroke/transient ischemic attack also increased significantly in the four functional regions, with the highest demand rate in the Core Functional Region.
More resources and effort should be devoted to pre-hospital EMS according to the increased pre-hospital EMS demand and prolonged ERT in Beijing over our 10-year study period. Changes in disease spectrum and differences between functional regions should also be considered.
本研究旨在描述和分析北京市的院前急救医疗服务（EMS），为政府和医疗机构提供信息，以优化 EMS。
我们收集了 2008 年至 2017 年北京市所有的院前急救数据。根据医疗优先调度系统（MPDS）对每个病例的主要投诉进行分类。通过地址的地理编码确定地点的行政区域，然后将其分为四个功能区。我们分析了北京市整体以及每个功能区的 EMS 需求、应急响应时间（ERT）和疾病谱。
共有 4192870 例符合纳入标准的院前 EMS 病例，2008 年至 2017 年间增加了 51.60%（P<0.001）。EMS 需求与人口呈正相关（r=0.946，P<0.001）。2008 年和 2017 年院前 EMS 需求率分别为每 10 万人 1907.05 和 2172.23，无显著变化（P=0.57）。ERT 显著增加（P=0.001），从 2008 年的 19.18 分钟增加到 2016 年的 24.51 分钟。根据 MPDS 分类，14 种疾病的院前救治需求增加，19 种疾病保持稳定，只有 1 种疾病减少。损伤相关疾病的病例显著增加，从 2017 年的约 90000 例增加到占所有院前 EMS 病例的 20%，且核心区域的需求率下降，郊区区域的需求率上升。四个功能区的心脏问题和中风/短暂性脑缺血发作的病例也显著增加，核心功能区的需求率最高。
在过去的 10 年研究中，北京市的院前 EMS 需求增加和 ERT 延长，应投入更多资源和努力来加强院前 EMS。还应考虑疾病谱的变化和功能区之间的差异。
