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运用有序逻辑回归模型预测急诊科的候诊和治疗时间。

Predicting waiting and treatment times in emergency departments using ordinal logistic regression models.

机构信息

Izmir Bakırçay University Çiğli Training and Research Hospital, Department of Emergency Medicine, Turkey.

Yaşar University, Department of Business, Turkey.

出版信息

Am J Emerg Med. 2021 Aug;46:45-50. doi: 10.1016/j.ajem.2021.02.061. Epub 2021 Mar 1.

Abstract

BACKGROUND

Since providing timely care is the primary concern of emergency departments (EDs), long waiting times increase patient dissatisfaction and adverse outcomes. Especially in overcrowded ED environments, emergency care quality can be significantly improved by developing predictive models of patients' waiting and treatment times to use in ED operations planning.

METHODS

Retrospective data on 37,711 patients arriving at the ED of a large urban hospital were examined. Ordinal logistic regression models were proposed to identify factors causing increased waiting and treatment times and classify patients with longer waiting and treatment times.

RESULTS

According to the proposed ordinal logistic regression model for waiting time prediction, age, arrival mode, and ICD-10 encoded diagnoses are all significant predictors. The model had 52.247% accuracy. The model for treatment time showed that in addition to age, arrival mode, and diagnosis, triage level was also a significant predictor. The model had 66.365% accuracy. The model coefficients had negative signs in the corresponding models, indicating that waiting times are negatively related to treatment times.

CONCLUSION

By predicting patients' waiting and treatment times, ED workloads can be assessed instantly. This enables ED personnel to be scheduled to better manage demand supply deficiencies, increase patient satisfaction by informing patients and relatives about expected waiting times, and evaluate performances to improve ED operations and emergency care quality.

摘要

背景

由于及时提供护理是急诊科(ED)的首要关注点,因此较长的等待时间会增加患者的不满和不良后果。特别是在人满为患的 ED 环境中,可以通过开发患者等待和治疗时间的预测模型来显著提高急诊护理质量,以便在 ED 运营规划中使用。

方法

对一家大型城市医院 ED 收治的 37711 名患者的回顾性数据进行了检查。提出了有序逻辑回归模型,以确定导致等待和治疗时间延长的因素,并对等待和治疗时间较长的患者进行分类。

结果

根据等待时间预测的提出的有序逻辑回归模型,年龄、入院方式和 ICD-10 编码诊断都是显著的预测因素。该模型的准确率为 52.247%。治疗时间模型表明,除了年龄、入院方式和诊断外,分诊级别也是一个显著的预测因素。该模型的准确率为 66.365%。相应模型中的模型系数具有负号,表明等待时间与治疗时间呈负相关。

结论

通过预测患者的等待和治疗时间,可以即时评估 ED 的工作量。这使 ED 人员能够更好地安排工作,以管理供需不足的情况,通过告知患者和家属预期的等待时间来提高患者的满意度,并评估绩效以改善 ED 运营和急诊护理质量。

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