A pilot study describing access to emergency care in two states using a model emergency care categorization system.
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
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一项试点研究使用模型紧急护理分类系统描述了两个州获得紧急护理的情况。
DOI：
10.1111/acem.12208
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Carr,BrendanG
中科院分区：
文献类型：
--
作者：
Myers,SageR;Salhi,RamaA;Lerner,EBrooke;Gilson,Rebecca;Kraus,Andrea;Kelly,JohnJ;Hargarten,Stephen;Carr,BrendanG
医学研究所（IOM）的“急诊护理的未来”报告建议的分类和区域化的急诊护理，但没有统一的系统来分类医院的急诊护理能力已经开发出来。缺乏这样一个系统限制了衡量结果的能力，限制了发展区域护理系统的能力，也限制了病人在寻求紧急护理时做出知情决定的能力。作者试图在两个state.MethodsA五层急诊科（艾德）分类系统的部署试点设计，并进行了调查，所有宾夕法尼亚州和威斯康星州的ED。这项46项调查描述了医院的人员配备，特点，资源和实践模式。根据回答，ED被分类为有限、基本、高级、综合和儿科重症监护能力。院前运输时间，然后使用，以确定人口获得每个层次的care.ResultsA共收到247份调查，从两个国家（247 297，83%）。在接受调查的机构中，大约四分之一的医院提供高级护理，10.5%提供综合护理，1.6%提供儿科重症护理。总体而言，75.1%的普通人群可以在60分钟内通过地面交通到达高级或综合艾德。在儿科人群（年龄14岁及以下），56.2%可以达到儿科重症监护或全面的艾德，与另外19.5%能够访问先进的艾德在60 minutes.ConclusionsUsing这种分类系统，不到一半的所有ED提供先进的或全面的急救护理。虽然大多数人可以在一小时内获得高级或全面的护理，但很大一部分人（25%）不能。本文介绍了如何艾德分类方案可以在美国各地开发和部署。这对院前计划、患者决策、结果测量、设施间转移协调和区域紧急护理系统的发展都有影响。
ObjectivesThe Institute of Medicine (IOM)'s “Future of Emergency Care” report recommended the categorization and regionalization of emergency care, but no uniform system to categorize hospital emergency care capabilities has been developed. The absence of such a system limits the ability to benchmark outcomes, to develop regional systems of care, and of patients to make informed decisions when seeking emergency care. The authors sought to pilot the deployment of an emergency care categorization system in two states.MethodsA five‐tiered emergency department (ED) categorization system was designed, and a survey of all Pennsylvania and Wisconsin EDs was conducted. This 46‐item survey described hospital staffing, characteristics, resources, and practice patterns. Based on responses, EDs were categorized as limited, basic, advanced, comprehensive, and pediatric critical care capable. Prehospital transport times were then used to determine population access to each level of care.ResultsA total of 247 surveys were received from the two states (247 of 297, 83%). Of the facilities surveyed, roughly one‐quarter of hospitals provided advanced care, 10.5% provided comprehensive care, and 1.6% provided pediatric critical care. Overall, 75.1% of the general population could reach an advanced or comprehensive ED within 60 minutes by ground transportation. Among the pediatric population (age 14 years and younger), 56.2% could reach a pediatric critical care or comprehensive ED, with another 19.5% being able to access an advanced ED within 60 minutes.ConclusionsUsing this categorization system, fewer than half of all EDs provide advanced or comprehensive emergency care. While the majority of the population has access to advanced or comprehensive care within an hour, a significant portion (25%) does not. This article describes how an ED categorization scheme could be developed and deployed across the United States. There are implications for prehospital planning, patient decision‐making, outcomes measurement, interfacility transfer coordination, and development of regional emergency care systems.
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影响因子：
4.4
作者：
Muelleman, Robert L.;Sullivan, Ashley F.;Camargo, Carlos A., Jr.
通讯作者：
Camargo, Carlos A., Jr.
DOI：
10.1016/s0735-1097(98)00395-7
发表时间：
1998-11-01
影响因子：
24
作者：
Brodie, BR;Stuckey, TD;Kelly, TA
通讯作者：
Kelly, TA
影响因子：
4.4
作者：
通讯作者：
--
美国急诊科分类的重要历史努力及其对区域化的影响。
DOI：
10.1111/j.1553-2712.2010.00931.x
发表时间：
2010
期刊：
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
影响因子：
--
作者：
A. Mehrotra;D. Sklar;V. Tayal;K. Kocher;D. Handel;R. Myles Riner
通讯作者：
R. Myles Riner
2005 年美国各州委员会认证急诊医生的供求情况。
DOI：
10.1111/j.1553-2712.2009.00509.x
发表时间：
2009
期刊：
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
影响因子：
--
作者：
A. Sullivan;A. Ginde;J. Espinola;C. Camargo
通讯作者：
C. Camargo