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急诊科应对 COVID-19 准备情况:法国的一项横断面研究。

COVID-19 Preparedness Among Emergency Departments: A Cross-Sectional Study in France.

机构信息

Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bichat, Emergency Department, Paris, France.

Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France.

出版信息

Disaster Med Public Health Prep. 2022 Feb;16(1):245-253. doi: 10.1017/dmp.2020.331. Epub 2020 Sep 10.

Abstract

OBJECTIVES

The aim of this study was to evaluate hospital and emergency department (ED) preparedness in France facing the coronavirus disease 2019 (COVID-19) rapid growth epidemic-phase, and to determine the link between preparedness and responsiveness.

METHODS

In this cross-sectional study, from March 7 to March 11, 2020, all heads of ED departments in France were contacted to answer an electronic survey, including 23 questions. Quality, Organization, Training, Resources, Management, Interoperability, and Responsiveness were evaluated by calculating scores (10 points). Multivariate analysis of variance was used to compare scores. Spearman's correlation coefficient and multifaceted regression analysis were performed between Responsiveness and dimensions scores.

RESULTS

A total of 287 of 636 French EDs were included (45.1%). Calculated scores showed (median): Quality 5.38; Organization 6.4; Training 4.6; Resources 4.13; Management 2.38; Interoperability 4.0; Responsiveness 6.25; seasonal influenza score was 5. Significant differences between scores as a function of hospital and ED main characteristics were found. Furthermore, we found significant correlations (P < 0.01) between Responsiveness and all preparedness dimensions. Organization (adjusted-R2 0.2897), Management (aR2 0.321), and Interoperability (aR2 0.422) were significantly associated with Responsiveness.

CONCLUSIONS

Preparedness in all its dimensions is low, indicating vulnerability. Preparedness and responsiveness face a certain and ongoing risk are close linked, and that Organizational, Management, and Interoperability dimensions are main determinants.

摘要

目的

本研究旨在评估法国医院和急诊科(ED)在应对 2019 年冠状病毒病(COVID-19)快速增长流行阶段的准备情况,并确定准备情况与反应能力之间的联系。

方法

在这项横断面研究中,于 2020 年 3 月 7 日至 3 月 11 日联系了法国所有 ED 部门的负责人回答电子调查,共包括 23 个问题。通过计算得分(10 分)来评估质量、组织、培训、资源、管理、互操作性和反应能力。采用方差分析对得分进行多变量分析。采用 Spearman 相关系数和多方面回归分析对反应能力和各维度得分之间的关系进行分析。

结果

共纳入 636 家法国 ED 中的 287 家(45.1%)。计算出的得分显示(中位数):质量 5.38;组织 6.4;培训 4.6;资源 4.13;管理 2.38;互操作性 4.0;反应能力 6.25;季节性流感得分 5。发现医院和 ED 主要特征的得分存在显著差异。此外,我们发现反应能力与所有准备维度之间存在显著相关性(P<0.01)。组织(调整后的 R2 0.2897)、管理(aR2 0.321)和互操作性(aR2 0.422)与反应能力显著相关。

结论

所有维度的准备工作都很低,表明存在脆弱性。准备工作和反应能力面临一定的和持续的风险,组织、管理和互操作性维度是主要决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddbd/7596573/b047ee31dbcc/S1935789320003316_fig1.jpg

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