浙江省急診搶救室患者滯留狀況的調(diào)查研究
發(fā)布時間：2019-03-28 15:26
【摘要】：目的：調(diào)查浙江省16家綜合性醫(yī)院急診搶救室滯留狀況,為進一步合理快速地分流搶救患者,提高急診服務質(zhì)量、完善醫(yī)院急診醫(yī)療服務體系提供依據(jù)。 方法：前瞻性的斷面調(diào)查研究。2012年12月17日至2012年12月23日全省16家綜合性三級醫(yī)院急診搶救患者的相關信息,包括出入搶救室時間,醫(yī)生決定患者住院時間及不同疾病分類,不同去向,不同急迫程度的患者的滯留時間及可能原因。并對比不同等級醫(yī)院上述結果的差別。 結果：①包括三甲醫(yī)院9家(其中附屬醫(yī)院4家),三乙醫(yī)院7家②全省共收集一周搶救患者1728例,急診滯留時間(0～350h),急診滯留的時間中位數(shù)為4.5h,(四分位數(shù)1.8-13.9h)；附屬醫(yī)院601例,急診滯留的時間中位數(shù)11.6h(四分位數(shù)2.8-24.7h)；非附屬醫(yī)院1127例,中位數(shù)3.3h(四分位數(shù)1.7-8.3h)。③不同等級醫(yī)院對比,非附屬三甲醫(yī)院與三乙醫(yī)院滯留時間無顯著差異,附屬醫(yī)院與非附屬醫(yī)院滯留時間存在顯著差異,搶救治療時間T2(p=0.001),初步搶救后決定住院到實際離開急診室的時間T3(p0.001)、從預檢分診開始到離開急診室的時間段T(p0.001),均是附屬醫(yī)院大于非附屬醫(yī)院。④不同去向搶救室患者滯留時間比：全省搶救患者滯留時間前三位為自動出院、入住普通病房、好轉出院；⑤不同疾病分類搶救患者滯留時間比：全省搶救患者滯留時間前三位為呼吸系統(tǒng)、多系統(tǒng)、循環(huán)系統(tǒng)；⑥滯留6h以上患者67.1%與普通病房無床相關。⑦滯留延長了患者總住院時間。 結論：2012年浙江省急診搶救室患者整體滯留尚不嚴重,但附屬醫(yī)院滯留已經(jīng)相當嚴重。其中以多系統(tǒng)疾病、呼吸系統(tǒng)、循環(huán)系統(tǒng)疾病滯留時間最長。主要與專科普通床位供應不足相關。同時發(fā)現(xiàn)自動出院患者及好轉出院患者對急診滯留造成一定影響。滯留對患者影響主要為延長了患者總住院時間。
[Abstract]:Aim: to investigate the detention status of emergency rescue rooms in 16 general hospitals in Zhejiang Province, in order to provide evidence for further rational and rapid diversion of patients, improvement of emergency service quality and improvement of hospital emergency medical service system. Methods: a prospective cross-sectional study was conducted. From December 17, 2012 to December 23, 2012, information about emergency patients in 16 level III hospitals in the province, including the time of entering and leaving the emergency room, was carried out. Doctors determine the stay time and possible causes of patients with different hospital stay and different disease categories, different destinations, and different degrees of urgency. And compare the difference of the above results in different grade hospitals. Results: 1There were 9 Grade A hospitals (including 4 affiliated hospitals), 7 hospitals (7 hospitals) and 7 hospitals (7 hospitals). A total of 1728 patients were collected for one week. The duration of emergency stay (0 / 350 hours) was 4.5 hours, and the median time of stay in emergency department was 4.5 hours. (quartile 1.8 / 13.9 h); There were 601 cases in affiliated hospital, the median stay time of emergency department was 11.6 h (quartile 2.8 / 24.7h). There were 1127 non-affiliated hospitals with a median of 3.3 h (1.7 / 8.3 h). 3. There was no significant difference in the stay time between non-affiliated tertiary A hospitals and Sanb hospitals, compared with different grade hospitals, and there was no significant difference in the stay time between non-affiliated tertiary A hospitals and Sanb hospitals. There was a significant difference in stay time between affiliated hospitals and non-affiliated hospitals. The time of rescue and treatment was T2 (p = 0.001). After initial rescue, the time between hospitalization and actual departure from the emergency room was T3 (p0.001). From the beginning of pre-examination and screening to leaving the emergency room, the time period T (p0.001) was larger in the affiliated hospital than in the non-affiliated hospital. 4 the retention time ratio of the patients in the emergency room at different directions: the first three stay times of the rescuers in the whole province were automatically discharged from the hospital. Admission to the general ward, improvement and discharge; (5) retention time ratio of patients with different diseases classification: respiratory system, multi-system and circulatory system were the first three stay time of rescuing patients in the whole province; 67.1% of the patients with more than 6 h detention were associated with bed-free in general ward. 7 the total hospitalization time of the patients was prolonged. Conclusion: the overall detention of patients in emergency rescue room in Zhejiang Province in 2012 is not serious, but the detention in affiliated hospitals is quite serious. Among them, multi-system disease, respiratory system, circulatory system disease stay time longest. It is mainly related to the shortage of specialized general beds. At the same time, it was found that automatic discharge patients and improved patients had a certain impact on emergency detention. The effect of retention on the patients was mainly to prolong the total length of hospitalization of the patients.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R459.7
本文編號：2448992
[Abstract]:Aim: to investigate the detention status of emergency rescue rooms in 16 general hospitals in Zhejiang Province, in order to provide evidence for further rational and rapid diversion of patients, improvement of emergency service quality and improvement of hospital emergency medical service system. Methods: a prospective cross-sectional study was conducted. From December 17, 2012 to December 23, 2012, information about emergency patients in 16 level III hospitals in the province, including the time of entering and leaving the emergency room, was carried out. Doctors determine the stay time and possible causes of patients with different hospital stay and different disease categories, different destinations, and different degrees of urgency. And compare the difference of the above results in different grade hospitals. Results: 1There were 9 Grade A hospitals (including 4 affiliated hospitals), 7 hospitals (7 hospitals) and 7 hospitals (7 hospitals). A total of 1728 patients were collected for one week. The duration of emergency stay (0 / 350 hours) was 4.5 hours, and the median time of stay in emergency department was 4.5 hours. (quartile 1.8 / 13.9 h); There were 601 cases in affiliated hospital, the median stay time of emergency department was 11.6 h (quartile 2.8 / 24.7h). There were 1127 non-affiliated hospitals with a median of 3.3 h (1.7 / 8.3 h). 3. There was no significant difference in the stay time between non-affiliated tertiary A hospitals and Sanb hospitals, compared with different grade hospitals, and there was no significant difference in the stay time between non-affiliated tertiary A hospitals and Sanb hospitals. There was a significant difference in stay time between affiliated hospitals and non-affiliated hospitals. The time of rescue and treatment was T2 (p = 0.001). After initial rescue, the time between hospitalization and actual departure from the emergency room was T3 (p0.001). From the beginning of pre-examination and screening to leaving the emergency room, the time period T (p0.001) was larger in the affiliated hospital than in the non-affiliated hospital. 4 the retention time ratio of the patients in the emergency room at different directions: the first three stay times of the rescuers in the whole province were automatically discharged from the hospital. Admission to the general ward, improvement and discharge; (5) retention time ratio of patients with different diseases classification: respiratory system, multi-system and circulatory system were the first three stay time of rescuing patients in the whole province; 67.1% of the patients with more than 6 h detention were associated with bed-free in general ward. 7 the total hospitalization time of the patients was prolonged. Conclusion: the overall detention of patients in emergency rescue room in Zhejiang Province in 2012 is not serious, but the detention in affiliated hospitals is quite serious. Among them, multi-system disease, respiratory system, circulatory system disease stay time longest. It is mainly related to the shortage of specialized general beds. At the same time, it was found that automatic discharge patients and improved patients had a certain impact on emergency detention. The effect of retention on the patients was mainly to prolong the total length of hospitalization of the patients.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R459.7
【參考文獻】
相關期刊論文 前1條
1 葉立剛;張茂;周光居;沈偉鋒;何小軍;干建新;徐少文;;綜合性三甲醫(yī)院急診室搶救患者滯留狀況的研究[J];實用醫(yī)院臨床雜志;2012年01期
，本文編號：2448992
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