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动态救护车调配:范围综述。

Dynamic ambulance relocation: a scoping review.

机构信息

Institute for Disaster and Emergency Management, Berlin, Germany.

Örebro Univeristy, Faculty of Medicine and Health, Orebro, Sweden.

出版信息

BMJ Open. 2023 Dec 14;13(12):e073394. doi: 10.1136/bmjopen-2023-073394.

Abstract

OBJECTIVES

Dynamic ambulance relocation means that the operators at a dispatch centre place an ambulance in a temporary location, with the goal of optimising coverage and response times in future medical emergencies. This study aimed to scope the current research on dynamic ambulance relocation.

DESIGN

A scoping review was conducted using a structured search in PubMed, Scopus and Web of Science. In total, 21 papers were included.

RESULTS

Most papers described research with experimental designs involving the use of mathematical models to calculate the optimal use and temporary relocations of ambulances. The models relied on several variables, including distances, locations of hospitals, demographic-geological data, estimation of new emergencies, emergency medical services (EMSs) working hours and other data. Some studies used historic ambulance dispatching data to develop models. Only one study reported a prospective, real-time evaluation of the models and the development of technical systems. No study reported on either positive or negative patient outcomes or real-life chain effects from the dynamic relocation of ambulances.

CONCLUSIONS

Current knowledge on dynamic relocation of ambulances is dominated by mathematical and technical support data that have calculated optimal locations of ambulance services based on response times and not patient outcomes. Conversely, knowledge of how patient outcomes and the working environment are affected by dynamic ambulance dispatching is lacking. This review has highlighted several gaps in the scientific coverage of the topic. The primary concern is the lack of studies reporting on patient outcomes, and the limited knowledge regarding several key factors, including the optimal use of ambulances in rural areas, turnaround times, domino effects and aspects of working environment for EMS personnel. Therefore, addressing these knowledge gaps is important in future studies.

摘要

目的

动态救护车调配是指调度中心的操作人员将救护车临时安置在某个位置,以优化未来医疗紧急情况下的覆盖范围和响应时间。本研究旨在对动态救护车调配的现有研究进行综述。

设计

采用PubMed、Scopus 和 Web of Science 中结构化搜索进行范围界定综述。共纳入 21 篇论文。

结果

大多数论文都描述了使用数学模型来计算救护车的最佳使用和临时调配的实验设计研究。这些模型依赖于多个变量,包括距离、医院位置、人口统计学-地理数据、新紧急情况的估计、紧急医疗服务(EMS)工作时间和其他数据。一些研究使用历史救护车派遣数据来开发模型。只有一项研究报告了对模型和技术系统的前瞻性、实时评估。没有研究报告关于救护车动态调配的积极或消极的患者结果或现实生活中的连锁效应。

结论

目前关于救护车动态调配的知识主要由数学和技术支持数据主导,这些数据根据响应时间而不是患者结果计算救护车服务的最佳位置。相反,缺乏关于患者结果和工作环境如何受到动态救护车派遣影响的知识。本综述突出了该主题在科学涵盖方面的几个差距。主要关注点是缺乏报告患者结果的研究,以及对几个关键因素的了解有限,包括在农村地区最佳使用救护车、周转时间、多米诺骨牌效应以及 EMS 人员工作环境方面。因此,在未来的研究中解决这些知识差距很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7ff/10729233/c10976de7aad/bmjopen-2023-073394f01.jpg

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