A profile of US emergency departments in 2001
A profile of US emergency departments in 2001
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DOI：
10.1016/j.annemergmed.2006.08.020
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发表时间：
2006-12-01
影响因子：
6.2
通讯作者：
Camargo, Carlos A., Jr.
中科院分区：
文献类型：
--
作者：
Sullivan, Ashley F.;Richman, Ilana B.;Camargo, Carlos A., Jr.
研究目的：急诊科（ED）提供24小时的急诊护理，但也作为一个医疗保健的“安全网”。“我们寻求确定的数量，分布和美国ED的特点，与长期的目标，改善获得紧急护理。方法：我们创建了一个库存的非联邦非专科美国医院使用2001年的数据从2个独立的来源。联系未报告艾德访视数据或2003年访视量变化较大的医院，以获得或验证访视量（n=437;占所有医院的9%）。ED被分为两组：每小时至少有1名患者，每天24小时，每周7天（>= 8，760次就诊/年）和那些就诊较少的ED。结果：在4，917家医院中，4，862家（99%）报告了ED。这些ED共接受了1.016亿次就诊。三分之一的ED（n= 1，535）每年接受不到8，760次访问;全国中位数为每年15，711次访问。排除低流量ED，其余3，327个报告了9520万次年度访问。典型的高容量艾德每年约有28，000次就诊; 28%（n=922）在非城市环境中。在所有ED中，人均就诊率因州而异，艾德就诊率最高的是华盛顿、西弗吉尼亚和密西西比。三分之一的急诊室的年就诊量不到8，760次，占所有就诊量的6%。美国应该考虑对急诊室进行分类，就像对创伤中心一样，以澄清在这种异质性临床环境中可用的护理类型以及不同类型急诊室的分布。
Study objective: Emergency departments (EDs) provide round-the-clock emergency care but also serve as a health care "safety net." We seek to determine the number, distribution, and characteristics of US EDs, with a long-term goal of improving access to emergency care.Methods: We created an inventory of nonfederal nonspecialty US hospitals using 2001 data from 2 independent sources. Hospitals that did not report ED visit data, or with large changes in visit volume by 2003, were contacted to obtain or verify visit volume (n=437; 9% of all hospitals). EDs were divided into 2 groups: those with at least 1 patient per hour, 24 hours per day, 7 days per week (>= 8,760 visits/year) and those with fewer visits.Results: Of 4,917 hospitals, 4,862 (99%) reported an ED. These EDs collectively received 101.6 million visits. One in 3 EDs (n=1,535) received less than 8,760 visits per year; the national median was 15,711 visits per year. Excluding the low-volume EDs, the remaining 3,327 reported 95.2 million annual visits. The typical higher-volume ED received approximately 28,000 visits per year; 28% (n=922) were in a nonurban setting. Among all EDs, per-capita visits varied by state, with the highest ED visit rates in Washington, DC; West Virginia; and Mississippi.Conclusion: Significant variation exists in the distribution and use of US EDs. One third of EDs have an annual visit volume less than 8,760 and, together, they account for 6% of all visits. The United States should consider classifying EDs, as it does trauma centers, to clarify the type of care available in this heterogeneous clinical setting and the distribution of different types of EDs.