Namgung Myeong, Bae Sung Jin, Chung Ho Sub, Jung Kwang Yul, Choi Yun Hyung, Kim Chan Woong, Gong Ye Lim, Lee Ji Yun, Lee Dong-Hoon
Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06973, Republic of Korea.
Department of Digital Strategy, Chung-Ang University Healthcare System, Seoul 06973, Republic of Korea.
Medicina (Kaunas). 2025 May 28;61(6):999. doi: 10.3390/medicina61060999.
: Medical residency programs play a crucial role in emergency departments (EDs). However, clinical processes may differ between EDs staffed with medical residents and those staffed only by attending physicians. This study aims to compare clinical process times and clinical outcomes between these two types of EDs. : A retrospective observational study was conducted, analyzing patients aged ≥ 18 years who visited an ED with a medical residency program and an ED staffed only by attending physicians. Time variables, including the time to first physician encounter, first order, CT order, consultation request, consulted specialist arrival, disposition decision, ED length of stay (LOS), and ED dispositions were compared between the two ED settings. : A total of 24,942 patients in an ED with a medical residency program and 19,867 patients in an ED staffed only by attending physicians were included in the final analysis. The ED with a medical residency program exhibited significantly longer times in all time variables including time to first physician encounter (7.0 [4.0-12.0] vs. 3.0 [1.0-5.0] min), first order (15.0 [9.0-23.0] vs. 9.0 [5.0-13.0] min), consultation request (95.0 [42.0-146.0] vs. 72.0 [27.0-124.0] min), consulted specialist arrival (156.0 [90.0-238.0] vs. 117.0 [63.0-176.0] min), and disposition decision (134.0 [70.0-208.0] vs. 92.0 [32.0-139.0] min). However, the proportion of discharges, admissions, and deaths were similar between the two EDs. : The ED with a medical residency program may contribute to delays in clinical processing times; however, it appears to have no significant impact on clinical outcomes.
医学住院医师培训项目在急诊科中发挥着关键作用。然而，配备医学住院医师的急诊科与仅由主治医生 staffed（此处原文可能有误，推测为staffed） 的急诊科之间的临床流程可能有所不同。本研究旨在比较这两种类型急诊科的临床流程时间和临床结果。：进行了一项回顾性观察研究，分析年龄≥18岁且前往设有医学住院医师培训项目的急诊科和仅由主治医生 staffed（此处原文可能有误，推测为staffed） 的急诊科就诊的患者。比较了两种急诊科环境下的时间变量，包括首次见到医生的时间、首次开医嘱的时间、CT检查医嘱时间、会诊请求时间、会诊专家到达时间、处置决定时间、急诊科住院时间（LOS）以及急诊科处置情况。：最终分析纳入了设有医学住院医师培训项目的急诊科的24942例患者和仅由主治医生 staffed（此处原文可能有误，推测为staffed） 的急诊科的19867例患者。设有医学住院医师培训项目的急诊科在所有时间变量上均表现出显著更长的时间，包括首次见到医生的时间（7.0 [4.0 - 12.0] 分钟对3.0 [1.0 - 5.0] 分钟）、首次开医嘱的时间（15.0 [9.0 - 23.0] 分钟对9.0 [5.0 - 13.0] 分钟）、会诊请求时间（95.0 [42.0 - 146.0] 分钟对72.0 [27.0 - 124.0] 分钟）、会诊专家到达时间（156.0 [90.0 - 238.0] 分钟对117.0 [63.0 - 176.0] 分钟）以及处置决定时间（134.0 [70.0 - 208.0] 分钟对92.0 [32.0 - 139.0] 分钟）。然而，两个急诊科的出院、入院和死亡比例相似。：设有医学住院医师培训项目的急诊科可能会导致临床处理时间延迟；然而，它似乎对临床结果没有显著影响。
