Emergency and Acute Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Front Public Health. 2022 Apr 25;10:711235. doi: 10.3389/fpubh.2022.711235. eCollection 2022.
Given the scarcity of resources, the increasing use of emergency departments (ED) represents a major challenge for the care of emergency patients. Current health policy interventions focus on restructuring emergency care with the help of patient re-direction into outpatient treatment structures. A precise analysis of ED utilization, taking into account treatment urgency, is essential for demand-oriented adjustments of emergency care structures.
Temporal and seasonal trends in the use of EDs were investigated, considering treatment urgency and hospital mortality. Secondary data of 287,119 ED visits between 2015 and 2017 of the two EDs of Charité Universitätsmedizin Berlin, Campus Charité Mitte and Campus Virchow Klinikum were analyzed.
EDs were used significantly more frequently on weekends than on weekdays (Mdn = 290 vs. 245 visits/day; < 0.001). The proportion of less urgent, outpatient emergency visits on weekends was above average. Holiday periods were characterized by at least 6, and at most 176 additional ED visits. In a comparison of different holidays, most ED visits were observed at New Year (+68% above average). In addition, a significant increase in in-hospital mortality on holidays was evident among inpatients admitted to hospital the ED (3.0 vs. 3.2%; < 0.001), with New Year's Day being particularly striking (5.4%).
These results suggest that, in particular, the resource planning of outpatient emergency treatment capacities on weekends and holidays should be adapted to the increased volume of non-urgent visits in EDs. Nevertheless, treatment capacities for the care of urgent, inpatient emergencies should not be disregarded and further research projects are necessary to investigate the causes of increased mortality during holiday periods.
鉴于资源的稀缺性，越来越多的人使用急诊科（ED）对急诊患者的护理构成了重大挑战。当前的卫生政策干预措施侧重于在患者重新定向到门诊治疗结构的帮助下，对急诊护理进行重构。对 ED 利用情况进行精确分析，考虑到治疗紧迫性，对于急诊护理结构的需求导向调整至关重要。
考虑到治疗紧迫性和医院死亡率，研究了 ED 使用的时间和季节性趋势。分析了 2015 年至 2017 年期间 Charité Universitätsmedizin Berlin 的两个 ED（Charité Mitte 和 Virchow Klinikum）的 287119 例 ED 就诊的次要数据。
ED 周末就诊的频率明显高于工作日（Mdn = 290 比 245 就诊/天；< 0.001）。周末非紧急、门诊急诊就诊的比例高于平均水平。假期期间至少有 6 次，最多有 176 次额外的 ED 就诊。在不同假期的比较中，大多数 ED 就诊发生在新年（比平均水平高出 68%）。此外，在因 ED 就诊而住院的住院患者中，假期期间住院死亡率明显升高（3.0%比 3.2%；< 0.001），尤其是在新年期间（5.4%）。
这些结果表明，特别是在周末和节假日，应根据 ED 中非紧急就诊量的增加，调整门诊急诊治疗能力的资源规划。然而，不应忽视紧急、住院患者的治疗能力，并且需要进一步的研究项目来调查假期期间死亡率增加的原因。
