School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
Emerg Med Australas. 2022 Aug;34(4):519-527. doi: 10.1111/1742-6723.13914. Epub 2021 Dec 15.
Understanding how people arrive to the ED assists in planning health services' response to fluctuating ED demand. The present study aimed to describe and compare demographics, clinical characteristics and health service outcomes of adult ED patient presentations based on mode of arrival: brought in by police (BIBP)/brought in by ambulance (BIBA)/privately arranged transport (PAT).
A retrospective cohort study of ED patient presentations made between 1 January 2018 and 31 December 2020 from all public hospital EDs across Queensland, Australia. Descriptive and inferential analyses were performed to ascertain presentation characteristics and predictors of health service outcomes.
From 4 707 959 ED presentations, 0.9% were BIBP, 34.8% were BIBA and 64.0% were PAT. Presentations BIBP were younger and comprised a higher proportion of mental health problems and Emergency Examination Authority orders compared to presentations BIBA or PAT. Compared to presentations BIBP or PAT, presentations BIBA were more likely to be assigned more urgent triage scores, be admitted to hospital, and have a longer ED length of stay (LOS). Compared to other modes of arrival, presentations arriving by PAT were more likely to be discharged and have a shorter ED LOS.
Presentations BIBA and BIBP encountered a longer ED LOS and higher admission rates than PAT, suggesting more complex care needs than those from PAT. Clinical care pathways for specific modes of arrival that support pre-hospital providers and patients and are considerate of the throughput and output stages of ED care may be needed.
了解人们到达急诊部的方式有助于规划卫生服务部门应对不断变化的急诊部需求。本研究旨在描述和比较基于到达方式的成年急诊部患者就诊的人口统计学、临床特征和卫生服务结果，到达方式包括：警察送来（BIBP）/救护车送来（BIBA）/私人安排的交通（PAT）。
这是一项回顾性队列研究，纳入了 2018 年 1 月 1 日至 2020 年 12 月 31 日期间澳大利亚昆士兰州所有公立医院急诊部的所有成年急诊部患者就诊。进行描述性和推断性分析以确定就诊特征和卫生服务结果的预测因素。
在 4707959 例急诊部就诊中，0.9%为 BIBP，34.8%为 BIBA，64.0%为 PAT。BIBP 就诊者更年轻，与 BIBA 或 PAT 就诊者相比，更有可能存在心理健康问题和紧急检查授权令。与 BIBP 或 PAT 就诊者相比，BIBA 就诊者更有可能被分配到更紧急的分诊评分，被收治入院，并且急诊部留观时间（LOS）更长。与其他到达方式相比，通过 PAT 到达的就诊者更有可能被出院，并且 ED LOS 更短。
BIBA 和 BIBP 就诊者的 ED LOS 和住院率均高于 PAT，这表明他们比 PAT 就诊者的护理需求更为复杂。可能需要为特定到达方式制定临床护理路径，以支持院前提供者和患者，并考虑急诊部护理的流程和输出阶段。
