Challenges in arranging interhospital transfers from a small regional hospital: an observational study.
Challenges in arranging interhospital transfers from a small regional hospital: an observational study.
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DOI：
10.1111/j.1742-6723.2005.00703.x
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发表时间：
2005-04-01
期刊：
影响因子：
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通讯作者：
Craig, Simon S
中科院分区：
文献类型：
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作者：
Craig, Simon S
目的：描述一家小型地区性医院急诊室的医院间转院过程。方法：对2003年2月至8月从维多利亚州西吉普斯兰医院急诊科转来的患者进行前瞻性观察病例系列。结果：以促进医院间转院所需的电话次数、接受拟议转院所需的时间和转院患者在急诊室的总时间来表示结果。结果：129名转院患者中有81人拥有所有可用的数据。那些缺少数据的人有相似的ED停留时间，年龄和敏锐度与那些有完整数据的人相似。研究人群的平均值(95%CI)为：打电话次数：4.7次(95%CI 3.96~5.43)；转接受理时间：56.7min(95%CI 19.1~94.8min)；急诊总时间：307min(95%CI 32.9~372.6 min)。男性(P=0.0 1)、老年患者(P=0.0 2)和接受中央转介服务的患者(P=0.006)更有可能需要4个或更多电话帮助转院。对于被转移到重症监护区的患者(P=0.02)和那些接受中央转诊服务的患者(P=0.002)，接受转院之前的时间更有可能超过一小时。转诊到另一急诊科的患者在WGH急诊科所花费的时间比其他转院的患者更少。结论：安排医院间转院所需的时间和电话数量差异很大，有些患者组需要更多的精力来组织转院。
OBJECTIVE: To describe the process of interhospital transfer from a small regional hospital ED.METHODS: Prospective observational case series of patients transferred from the ED of West Gippsland Hospital (WGH), Victoria from February to August 2003. Outcome measures were expressed as the number of phone calls required to facilitate interhospital transfer, the time taken for a proposed transfer to be accepted and the total time a transferred patient spent in the ED.RESULTS: Eighty-one of 129 transferred patients had all data available. Those with missing data had similar ED length of stays, and were of similar age and acuity to those with complete data available. Mean (95% CI) values for the study population were number of phone calls: 4.7 (95% CI 3.96-5.43); time to transfer acceptance: 56.7 min (95% CI 19.1-94.8 min); and total time in ED: 307 min (95% CI 32.9-372.6 min). Men (P = 0.01), older patients (P = 0.02) and those for whom a centralized referral service were consulted (P = 0.006) were more likely to require four or more phone calls to facilitate transfer. The time until a transfer was accepted was more likely to be longer than an hour for patients who were transferred to critical care areas (P = 0.02) and those for whom a centralized referral service was consulted (P = 0.002). Patients referred to another ED spent less time in WGH ED than other transferred patients.CONCLUSION: There is wide variation in the time taken and the number of phone calls to arrange an interhospital transfer, with some patient groups requiring more effort to organize a transfer.