急診停留時間過長病患之特徵分析

An analysis of the Characteristics of Patients with Prolonged Stays in an Emergency Department

梁素琴(Su-Chin Liang) ； 戴玫瑰(Mei-Kuei Tai) ； 莊玉仙(Yu-Hsine Chuang)

《醫務管理期刊》 12卷4期 (2011/12) Pp. 237-247

https://doi.org/10.6174/JHM2011.12(4).237

摘要

Objectives: Prolonged stays in an emergency department (ED) are an important factor in ED crowding. This study compared characteristics of patients with different dispositions from an ED.Methods: This was a cross-sectional study design. The sample was composed of selected patients who visited the ED at a medical center in southern Taiwan in 2008. Data were collected from the computer-based information system.Results: A total of 24,322(28.9%) patients stayed in the ED for over 6 hours. Of those patients, 52.1%, (n =12,670), were male, 18.6% (n = 4524) were aged 75 or over, 46.8% (n = 11,380) were in triage category 3, 61.7% (n = 15,008) were medical patients, and 39.3% (n =9,548) were admitted during the day shift. Among these patients who stayed more than 6 hours, gender, age, and triage category were found to be significantly different between ”may be discharged” and ”hospitalize” dispositions. Approximately 10% had unscheduled returns to the ED within 3 days after ”may be discharged” and 85.7% of those returns were associated with the same diagnosis as on the previous visits. There was a signification correlation (r =0.221, p＜0.05) between the number of ED visits and stays over 6 hours.Conclusions: The study results indicated that patients who stayed in the ED for more than 6 hours had high percentages of hospitalization (50%) and readmission (30%). If these patients could be identified and hospitalized sooner, then they would spend less time in the ED. Appropriated admission policies and required patient education and monitoring might also decrease ED crowding.

關鍵字

急診停留時間 ； 非計畫重返急診 ； 急診壅塞

並列摘要

Objectives: Prolonged stays in an emergency department (ED) are an important factor in ED crowding. This study compared characteristics of patients with different dispositions from an ED.Methods: This was a cross-sectional study design. The sample was composed of selected patients who visited the ED at a medical center in southern Taiwan in 2008. Data were collected from the computer-based information system.Results: A total of 24,322(28.9%) patients stayed in the ED for over 6 hours. Of those patients, 52.1%, (n =12,670), were male, 18.6% (n = 4524) were aged 75 or over, 46.8% (n = 11,380) were in triage category 3, 61.7% (n = 15,008) were medical patients, and 39.3% (n =9,548) were admitted during the day shift. Among these patients who stayed more than 6 hours, gender, age, and triage category were found to be significantly different between ”may be discharged” and ”hospitalize” dispositions. Approximately 10% had unscheduled returns to the ED within 3 days after ”may be discharged” and 85.7% of those returns were associated with the same diagnosis as on the previous visits. There was a signification correlation (r =0.221, p＜0.05) between the number of ED visits and stays over 6 hours.Conclusions: The study results indicated that patients who stayed in the ED for more than 6 hours had high percentages of hospitalization (50%) and readmission (30%). If these patients could be identified and hospitalized sooner, then they would spend less time in the ED. Appropriated admission policies and required patient education and monitoring might also decrease ED crowding.

並列關鍵字

emergency department ； prolonged stay ； unscheduled returns ； crowding

參考文獻

吳秋芬、吳肖琪、石富元、許銘能(2008)。影響急診病患暫留時間之相關因素探討。臺灣衛誌。27(6)，507-518。

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Yoon, P.,Steiner, I.,Reinhardt, G.(2003).Analysis of factors influencing length of stay in the emergency department.CJEM.5(3),151-161.

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Pines, J.M.,Iyer, S.,Disbot, M.,Hollander, J.E.,Shofer, F.S.,Datner, E.M.(2008).The Effect of Emergency Department Crowding on Patient Satisfaction for Admitted Patients.Academic Emergency Medicine.15(9),825-831.