高容量三级儿科急诊的床位利用和过度拥挤情况。

Bed Utilization and Overcrowding in a High-Volume Tertiary Level Pediatric Emergency Department.

机构信息

Pediatric Emergency and Intensive Care Units, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Pediatric Emergency and Intensive Care Units, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Correspondence to:Dr Muralidharan Jayashree, Professor, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012.

出版信息

Indian Pediatr. 2021 Aug 15;58(8):723-725. Epub 2021 Feb 25.

PMID:33634795

Abstract

OBJECTIVE

To measure bed utilization rate and overcrowding in a high-volume tertiary level pediatric emergency department (ED) and correlate with outcome.

METHODS

All children beyond neonatal age attending the 22-bedded emergency were prospectively enrolled from February to December, 2019. Number of daily admissions, boarders, discharges, ward transfers, length of stay (LOS) and unfavorable outcomes (care discontinuation and deaths) were recorded. Daily bed occupancy rate (BOR) was calculated and correlated with unfavorable outcome.

RESULTS

A total of 17,463 children visited the ED during the study period. The median (IQR) daily attendance and admission rate was 58 (51,65) and 22 (17,26) patients, respectively. The median (IQR) number of boarders and BOR was 48 (40-58) and 218% (181-263%), respectively. The median (IQR) LOS was 42.7 (23-71.4) hours. Unfavorable outcome correlated positively with number of boarders and BOR (P<0.001).

CONCLUSIONS

Overcrowding of the ED was associated with increased frequency of care discontinuation and mortality. This data calls for systemic changes to tackle overcrowding.

摘要

目的

测量一家大容量三级儿科急诊（ED）的床位使用率和过度拥挤情况，并将其与结果相关联。

方法

2019 年 2 月至 12 月，前瞻性招募了所有超过新生儿年龄在 22 张床位的急诊就诊的儿童。记录每天的入院人数、留观人数、出院人数、病房转科人数、住院时间（LOS）和不良结局（停止治疗和死亡）。计算每日床位占用率（BOR）并与不良结局相关联。

结果

在研究期间，共有 17463 名儿童就诊于 ED。中位数（IQR）每日就诊和入院率分别为 58（51，65）和 22（17，26）例。中位数（IQR）留观人数和 BOR 分别为 48（40-58）和 218%（181-263%）。中位数（IQR）LOS 为 42.7（23-71.4）小时。不良结局与留观人数和 BOR 呈正相关（P<0.001）。