Wrede Julian, Wrede Helge, Behringer Wilhelm
Department of Emergency Medicine, Faculty of Medicine, University of Jena, Am Klinikum 1, 07747 Jena, Germany.
Höltystraße 9, 22085 Hamburg, Germany.
J Clin Med. 2020 Nov 20;9(11):3725. doi: 10.3390/jcm9113725.
One key element for emergency department (ED) staff calculation is the mean physician time per patient (MPTPP) and its influencing factors. The aims of this study were measuring the MPTPP, identifying factors with significant influence on the MPTPP, and developing a model to predict the MPTPP. This study was a prospective trial conducted at the ED of a university hospital in Germany. The MPTPP was measured with a specifically developed app. The influence of different factors on MPTPP were first tested in univariate analysis. Then, all significant factors were used in a multivariant regression model to minimize collinearities and to develop a prediction model. In total, 202 patients treated by 32 different physicians were observed within one year. The MPTPP was 47 min (standard deviation: 34 min). Relevant factors influencing the MPTPP were treatment area, Emergency Severity Index (ESI) triage level, guiding symptom category, and physician level (all < 0.001). This model predicted 45% of the variance in the MPTPP ( < 0.001), which corresponds to a large effect size. We developed an effective prediction model for ED MPTPP, resulting in an MPTPP of 47 min. Future studies are needed to validate our model, which could serve as a benchmark for other EDs where the MPTPP is not available.
急诊科(ED)工作人员计算的一个关键要素是每位患者的平均医生诊疗时间(MPTPP)及其影响因素。本研究的目的是测量MPTPP,识别对MPTPP有显著影响的因素,并开发一个预测MPTPP的模型。本研究是在德国一家大学医院的急诊科进行的一项前瞻性试验。MPTPP通过一个专门开发的应用程序进行测量。不同因素对MPTPP的影响首先在单变量分析中进行测试。然后,所有显著因素被用于多变量回归模型,以最小化共线性并开发一个预测模型。在一年内共观察了由32位不同医生治疗的202名患者。MPTPP为47分钟(标准差:34分钟)。影响MPTPP的相关因素有治疗区域、急诊严重程度指数(ESI)分诊级别、主要症状类别和医生级别(均P<0.001)。该模型预测了MPTPP中45%的方差(P<0.001),这对应于一个较大的效应量。我们为急诊科MPTPP开发了一个有效的预测模型,得出MPTPP为47分钟。未来需要进行研究以验证我们的模型,该模型可作为其他无法获取MPTPP的急诊科的基准。