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中型社区医院系统非紧急急诊就诊的预测因素:行政医疗保健数据的二次分析

Predictors of Nonurgent Emergency Visits at a Midsize Community-Based Hospital System: Secondary Analysis of Administrative Health Care Data.

作者信息

El-Masri Maher, Bornais Judy, Omar Abeer, Crawley Jamie

出版信息

J Emerg Nurs. 2020 Jul;46(4):478-487. doi: 10.1016/j.jen.2020.02.002. Epub 2020 Jun 4.

Abstract

INTRODUCTION

Nonurgent visits to the emergency department compromise efficiency in treating patients with urgent conditions and inversely influence the satisfaction of patients and staff. There is inconclusive evidence of the factors associated with nonurgent ED visits. Therefore, the purpose of this study was to explore the independent factors associated with nonurgent ED visits in a midsize community-based Canadian hospital system.

METHODS

This was a retrospective, secondary analysis of data from 2 community hospitals in southwestern Ontario, Canada. We included ED patients in the analysis if they were local residents from the city or the surrounding county.

RESULTS

Nonurgent visits constituted approximately 27% of all ED visits and were more likely to be associated with patients with a primary care provider referral (odds ratio = 2.87; 95% confidence interval, 2.75-2.99) and with patients who had no primary care provider (odds ratio = 1.10; 95% confidence interval, 1.04-1.16). Other predictors included younger age, season, time of day, ED arrival mode, geographical proximity of residence to the emergency department, and case presentation.

DISCUSSION

The findings of this study may assist health care providers and stakeholders in developing strategies to minimize nonurgent ED visits.

摘要

引言

非紧急情况下前往急诊科就诊会影响紧急情况患者的治疗效率,进而对患者和医护人员的满意度产生负面影响。关于非紧急急诊科就诊相关因素的证据尚无定论。因此,本研究旨在探讨加拿大一个中等规模社区医院系统中与非紧急急诊科就诊相关的独立因素。

方法

这是一项对加拿大安大略省西南部两家社区医院数据的回顾性二次分析。如果急诊患者是该市或周边县的当地居民,我们将其纳入分析。

结果

非紧急就诊约占所有急诊科就诊的27%,更有可能与有初级保健提供者转诊的患者(比值比 = 2.87;95%置信区间,2.75 - 2.99)以及没有初级保健提供者的患者(比值比 = 1.10;95%置信区间,1.04 - 1.16)相关。其他预测因素包括年龄较小、季节、一天中的时间、到达急诊科的方式、居住地与急诊科的地理距离以及病例呈现情况。

讨论

本研究结果可能有助于医疗保健提供者和利益相关者制定策略,以尽量减少非紧急急诊科就诊情况。

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