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[德国急诊科数据登记处(AKTIN)——来自急诊医学的实时数据:15个急诊科的实施情况及初步结果,重点关注联邦联合委员会的 acuity 评估指南]

[AKTIN - The German Emergency Department Data Registry - real-time data from emergency medicine : Implementation and first results from 15 emergency departments with focus on Federal Joint Committee's guidelines on acuity assessment].

作者信息

Brammen D, Greiner F, Kulla M, Otto R, Schirrmeister W, Thun S, Drösler S E, Pollmanns J, Semler S C, Lefering R, Thiemann V S, Majeed R W, Heitmann K U, Röhrig R, Walcher F

机构信息

Universitätsklinik für Unfallchirurgie, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.

Universitätsklinik für Anästhesiologie und Intensivtherapie, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2022 Feb;117(1):24-33. doi: 10.1007/s00063-020-00764-2. Epub 2020 Dec 21.

Abstract

BACKGROUND

Emergency care in Germany is in transition. Emergency departments (EDs) treat their patients based on symptoms and acuity. However, this perspective is not reflected in claims data. The aim of the AKTIN project was to establish an Emergency Department Data Registry as a data privacy-compliant infrastructure for the use of routine medical data.

METHODS

Data from the respective documentation systems are continuously transmitted to local data warehouses using a standardized interface. They are available for several applications such as internal reports but also multicentre studies, in compliance with data privacy regulations. Based on a 12-months period we evaluate the population with focus on acuity assessment (triage) and vital parameters in combination with presenting complaints.

RESULTS

For the period April 2018 to March 2019, 436,149 cases from 15 EDs were available. A triage level is documented in 86.0% of cases, and 70.5% were triaged within 10 min of arrival. Ten EDs collected a presenting complaint regularly (82.3%). The respective documentation of vital signs shows plausible patterns.

CONCLUSIONS

The AKTIN registry provides an almost real-time insight into German EDs, regardless of the primary documentation system and health insurance claims data. The Federal Joint Committee's requirements are largely met. Standardized presenting complaints allow for symptom-based analyses as well as health surveillance.

摘要

背景

德国的急诊护理正在转型。急诊科根据症状和 acuity 来治疗患者。然而,这种观点在理赔数据中并未得到体现。AKTIN 项目的目的是建立一个急诊科数据登记处,作为一个符合数据隐私规定的基础设施,用于使用常规医疗数据。

方法

来自各自文档系统的数据通过标准化接口持续传输到本地数据仓库。它们可用于多种应用,如内部报告以及多中心研究,且符合数据隐私法规。基于 12 个月的时间段,我们重点评估了 acuity 评估(分诊)和生命体征参数,并结合就诊时的主诉。

结果

在 2018 年 4 月至 2019 年 3 月期间,有来自 15 个急诊科的 436,149 例病例。86.0%的病例记录了分诊级别,70.5%的患者在到达后 10 分钟内完成分诊。10 个急诊科定期收集就诊时的主诉(82.3%)。生命体征的相应记录显示出合理的模式。

结论

AKTIN 登记处几乎可以实时洞察德国的急诊科情况,无论其主要文档系统和医疗保险理赔数据如何。基本满足了联邦联合委员会的要求。标准化的就诊主诉便于进行基于症状的分析以及健康监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8e3/8782797/1b9ccb59643f/63_2020_764_Fig1_HTML.jpg

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