Influenza assessment centres: a case study of pandemic preparedness to alleviate excess emergency department volume
Influenza assessment centres: a case study of pandemic preparedness to alleviate excess emergency department volume
复制标题
DOI：
10.2310/8000.2012.120808
复制
发表时间：
2013-07-01
影响因子：
2.4
通讯作者：
Moore, Kieran M.
中科院分区：
文献类型：
--
作者：
Hall, Geoffrey G.;Perry, Alexander G.;Moore, Kieran M.
目标：2009 年秋季，在加拿大安大略省金斯顿、弗龙特纳克、伦诺克斯和阿丁顿 (KFL&A) 公共卫生区，部署流感评估中心 (IAC) 以减少 pH1N1 流感爆发期间急诊科 (ED) 就诊量。我们提出了一项案例研究，说明在大流行和季节性传染病爆发期间部署 IAC 以减少急诊科 (ED) 就诊量。触发部署八个地理分布的 IAC，并在 3 周后交错关闭。我们通过时间序列回归分析，在 IAC 操作之前、期间和之后，将 KFL&A 地区的实际和预期急诊就诊量与未进行 IAC 操作的邻近地区进行了比较。结果：IAC 的部署是随着 KFL&A 地区医院整体急诊就诊量上升至比 6 个月运行平均值高出 10% 的水平而触发的。 IAC 在 3 周的手术期间评估了 2,284 名患者。 33 名患者绕过急诊室，直接从 IAC 入院。在 IAC 运行期间，KFL&A 地区的医院每日就诊量与前 3 周相比略有下降。在 IAC 运营期间，邻近地区医院的整体急诊就诊量增加了 105%。结论：正如在预期大流行情况下观察到的那样，在需求增加期间，运营独立的流感 IAC 可能会减少急诊就诊量。
Objectives: Influenza assessment centres (IACs) were deployed to reduce emergency department (ED) volumes during the pH1N1 influenza outbreak in the Kingston, Frontenac, Lennox and Addington (KFL&A) public health region of Ontario, Canada, in the fall of 2009. We present a case study for the deployment of IACs to reduce ED visit volume during both periods of pandemic and seasonal communicable disease outbreak.Methods: An emergency department syndromic surveillance system was used to trigger the deployment of eight geographically distributed IACs and to time their staggered closure 3 weeks later. We compared actual and expected ED visit volumes in the KFL&A region to neighbouring regions where no IACs operated by time series regression analysis before, during, and after IAC operation.Results: The deployment of IACs was triggered with a rise in overall ED volume at the hospitals in the KFL&A region to a level 10% above the 6-month running average. The IACs assessed 2,284 patients during 3 weeks of operation. Thirtythree patients were admitted directly to the hospital from the IACs, bypassing the EDs. During the operation of the IACs, the hospitals in the KFL&A region experienced a modest decrease in daily visits when compared to the 3 previous weeks. Overall ED visit volume in the hospitals in the neighbouring regions increased 105% during the period of IAC operation.Conclusions: Operating stand-alone influenza IACs may reduce ED volumes during periods of increased demand, as observed during an anticipated pandemic situation.