Declining emergency department visits and costs during the severe acute respiratory syndrome (SARS) outbreak
Declining emergency department visits and costs during the severe acute respiratory syndrome (SARS) outbreak
复制标题
DOI：
10.1016/s0929-6646(09)60106-6
复制
发表时间：
2006-01-01
影响因子：
3.2
通讯作者：
Lee, CH
中科院分区：
文献类型：
--
作者：
Huang, HH;Yen, DHT;Lee, CH
背景：严重急性呼吸系统综合征（SARS）暴发对急诊科（ED）访问量和这些访问量的医院支出的即时和长期影响尚未得到彻底调查。本回顾性观察性研究的目的是调查SARS爆发对急诊科就诊的影响以及在指定的SARS医疗中心就诊的费用。方法：收集2003年和2002年SARS流行期间急诊总人次及费用等相关数据。收集的数据包括急诊科总访问量、提供的服务、分诊类别和所有患者的总支出。检索并比较了爆发前和爆发期间的数据。结果：在SARS流行高峰期，每日急诊科就诊次数比流行前减少51.6% （p < 0.01）。在儿童、创伤和非创伤患者中，最大平均就诊次数分别减少80.0% （p < 0.01）、57.6% （p < 0.01）和40.8% （p < 0.01）。分诊1、2、3组患者的最大平均降幅分别为18.1% （p < 0.01）、55.9% （p < 0.01）、53.7% （p < 0.01）。总成本最大降幅为37.7% （p < 0.01）。每位患者的最高平均费用增加35.9% （p < 0.01）。每位患者平均费用增加的比例归因于实验室检查（31.4%）、放射检查（21.9%）和药物治疗（29.5%）。结论：SARS疫情结束后，急诊科就诊人数明显减少，并持续3个月。治疗个体患者的总成本同时显着增加，而急诊科的总操作成本显着降低。每位病人的总费用增加是由于急诊科筛查可能的SARS的诊断程序数量增加。
Background: The immediate and long-term impact of severe acute respiratory syndrome (SARS) outbreak on emergency department (ED) visits and hospital expenditures for these visits has not been thoroughly investigated. The objectives of this retrospective observational study investigated the impact of SARS outbreak on ED visits and the cost of these visits in a designated SARS medical center. Methods: Data related to the total number of ED visits and their costs were collected for the SARS epidemic period in 2003 and the same period in the preceding year in 2002. Data collected included total number of ED visits, services provided, triage categories, and total expenditures for all patients. Data for before and during the outbreak were retrieved and compared. Results: At the peak of the SARS epidemic, the reduction in daily ED visits reached 51.6% of pre-epidemic numbers (p < 0.01). In pediatric, trauma and non-trauma patients, the maximum mean decreases in number of visits were 80.0% (p < 0.01), 57.6% (p < 0.01) and 40.8% (p < 0.01), respectively. In triage 1, 2 and 3 patients, the maximum mean decreases were 18.1% (p < 0.01), 55.9% (p < 0.01) and 53.7% (p < 0.01), respectively. The maximum decrease in total costs was 37.7% (p < 0.01). The maximum mean costs per patient increased 35.9% (p < 0.01). The proportions of increases in mean costs for each patient were attributed to laboratory investigations (31.4%), radiography (21.9%) and medications (29.5%). Conclusion: The SARS outbreak resulted in a marked reduction in the number of ED visits which persisted for 3 months after the end of the epidemic. Total cost of treating individual patients showed a simultaneous marked increase, while overall operational costs in the ED showed a marked decrease. The increased total cost for each patient was attributed to the increased number of diagnostic procedures to screen for possible SARS in the ED.