Creation of a Novel National Dataset Through Linkage of Emergency Medical Services (EMS) Transport Destination and Verified Emergency Department (ED) Capability.

IF 2.1 3区 医学 Q2 EMERGENCY MEDICINE
Rebecca E Cash, Remle P Crowe, Maeve Swanton, Krislyn M Boggs, Scott A Goldberg, Ashley F Sullivan, Carlos A Camargo, Kori S Zachrison
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引用次数: 0

Abstract

Objective: Emergency department (ED) capabilities, such as trauma center or stroke center designation, are key to understanding the effects of emergency medical services (EMS) transport destination decisions on patient outcomes. In current EMS datasets, ED capabilities are self-reported by the EMS clinician or agency. The reliability and validity of the EMS-reported ED capabilities is unknown. Our objective was to link EMS transport destinations with verified ED capability data to develop a novel national dataset to better understand prehospital routing practices.

Methods: We linked two cross-sectional databases: the 2021 ESO Data Collaborative and the 2021 National Emergency Department Inventory (NEDI)-USA. The ESO Data Collaborative contains de-identified prehospital patient care records from nearly 2,000 participating EMS agencies across the United States. The NEDI-USA is a survey of all nonfederal, non-specialty U.S. EDs open 24/7/365 (including freestanding EDs), with verified stroke, trauma, and burn capability data. From EMS records, we obtained all unique destinations designated as "hospital" as of 2021. After verifying addresses were NEDI-eligible EDs (i.e., providing emergency services 24/7/365), we performed a 3-step linkage process to NEDI-USA: (1) name/address exact matches; (2) probabilistic matching on name/address based on bigrams, accepting adequate (>85%) match scores after review; and (3) hand-matching using Google Maps. We calculated descriptive statistics to describe the linkage process.

Results: Of the 9,420 unique "hospital" destinations in the EMS dataset, 2,714 (29%) were non-hospital facilities (e.g., nursing home) or were non-NEDI-eligible (e.g., specialty hospital such as a psychiatric facility). We linked 98% (n = 6,605/6,706) of NEDI-eligible EMS hospital transport destinations to EDs in NEDI-USA. Excluding duplicate addresses for a single hospital (e.g., ED address versus main entrance address), the linked addresses represented 3,877 unique EDs in 49 states, which included 68% (n = 3,821/5,580) of the EDs included in the 2021 NEDI-USA database.

Conclusions: We successfully linked 98% of EMS ED transport destinations to verified ED capability information. This novel linked dataset now includes rich destination capability information associated with each EMS transport that can be leveraged for describing and improving routing practices for specific patient conditions, such as patients with stroke-like symptoms to stroke centers or major traumas to verified trauma centers.

通过连接EMS运输目的地和经过验证的ED能力,创建一个新的国家数据集。
目的:急诊科(ED)的能力,如创伤中心或中风中心的指定,是理解紧急医疗服务(EMS)运输目的地决定对患者预后影响的关键。在当前的EMS数据集中,ED能力是由EMS临床医生或机构自我报告的。ems报告的ED能力的可靠性和有效性尚不清楚。我们的目标是将EMS运输目的地与经过验证的ED能力数据联系起来,以开发一个新的国家数据集,以更好地了解院前路由实践。方法:我们连接了两个横断面数据库:2021年ESO数据协作和2021年美国国家急诊科库存(NEDI)。ESO数据协作包含来自美国近2000家参与EMS机构的院前患者护理记录。NEDI-USA是一项对美国所有非联邦、非专业急诊室(包括独立急诊室)的调查,其中包括经过验证的中风、创伤和烧伤能力数据。从EMS记录中,我们获得了截至2021年指定为“医院”的所有独特目的地。在验证地址是否符合nedi资格的急诊中心(即全天候提供紧急服务)后,我们执行了与NEDI-USA的三步联动流程:1)名称/地址精确匹配;2)基于双引号的姓名/地址概率匹配,经过审核后接受足够(>85%)的匹配分数;3)使用谷歌地图进行手工匹配。我们计算了描述性统计来描述联动过程。结果:在EMS数据集中的9,420个独特的“医院”目的地中,2,714个(29%)是非医院设施(例如养老院)或非nedi资格(例如精神病院等专科医院)。我们将98% (n = 6605 / 6706)符合nedi条件的EMS医院转运目的地与NEDI-USA的急诊科联系起来。排除同一家医院的重复地址(例如,急诊科地址与正门地址),链接的地址代表49个州的3,877个唯一急诊科,其中包括2021年NEDI-USA数据库中包含的68% (n = 3,821/5,580)急诊科。结论:我们成功地将98%的EMS ED运输目的地与经过验证的ED能力信息联系起来。这个新颖的关联数据集现在包含了与每个EMS运输相关的丰富目的地能力信息,可以用于描述和改进特定患者情况的路线实践,例如将有中风样症状的患者送到中风中心或将重大创伤送到经过验证的创伤中心。
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来源期刊
Prehospital Emergency Care
Prehospital Emergency Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.30
自引率
12.50%
发文量
137
审稿时长
1 months
期刊介绍: Prehospital Emergency Care publishes peer-reviewed information relevant to the practice, educational advancement, and investigation of prehospital emergency care, including the following types of articles: Special Contributions - Original Articles - Education and Practice - Preliminary Reports - Case Conferences - Position Papers - Collective Reviews - Editorials - Letters to the Editor - Media Reviews.
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