急救中心紧急状况评估的准确性与未提供紧急医疗服务之间的相关性:一项基于芬兰登记册的回顾性研究。

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE
Tomi Salminen, Kaius Kaartinen, Mira Palonen, Piritta Setälä, Eija Paavilainen, Sanna Hoppu
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引用次数: 0

摘要

背景:在现代紧急医疗服务(EMS)中,救护车越来越注重在现场对病人进行检查和治疗。这导致不转运的情况越来越多。例如,在芬兰,约有 40% 的急救医疗服务派遣以未转送告终。随着急救医疗系统的发展,如果能与紧急状况评估的表现建立联系,那么不转送的比例可以作为评估派遣标准质量的一种经济有效的衡量标准。本研究的目的是调查未转达的比例是否与紧急状况评估的测试性能水平相关。这项调查在每个调度类别中分别进行:对皮尔坎马医院区 2021 年 8 月 1 日至 2021 年 8 月 31 日的所有急救医疗派遣数据进行了回顾性评估。研究期间共有 7,245 次急救服务派遣,其中 829 次被排除在外。本研究通过比较急救中心紧急状况评估的现有测试性能水平(灵敏度、特异性、低估或高估)与各派遣类别的未传达率(%)来进行。各变量之间的关系采用斯皮尔曼等级相关系数进行测量:结果:过度分流比例是唯一一个与未转达比例有显著统计学相关性(r = 0.568; p = 0.003)的紧急程度评估测试绩效变量。紧急程度评估的其他测试性能变量与未转送比例没有相关性或相关性很小。在研究期间的 6,416 次急救派遣中,42%(2,672 次)的患者未被转运。在 9 个派遣类别中,至少有一半(51%-69%)的派遣以不转达病人信息告终:根据这项研究,在有一定限制的情况下,似乎可以使用派遣类别中未转运的百分比来评估派遣类别中过度分流的比例。该方法尤其适用于调度标准经过修改,且需要监测修改对过度调度水平的影响的情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Correlation between the accuracy of the emergency response centre's urgency assessment and emergency medical services non-conveyance: a retrospective register-based study in Finland.

Background: In modern emergency medical services (EMS), ambulances increasingly focus on examining and treating the patient at the scene. This has led to increased levels of non-conveyance. In Finland, for instance, approximately 40% of EMS dispatches end up in non-conveyance. As EMS systems evolve, the proportion of non-conveyance could serve as a cost-effective measure to assess the quality of the dispatch criteria, if a link to the performance of urgency assessment would be established. The purpose of this study was to investigate whether the proportion of non-conveyance is associated with the test performance levels of the urgency assessment. This investigation was done separately within each dispatch category.

Methods: A retrospective evaluation of the data was conducted on all EMS dispatches in the Pirkanmaa Hospital District from 1 August 2021 through 31 August 2021. There were a total of 7,245 EMS dispatches during the study period of which 829 were excluded. This study was conducted by comparing the existing test performance levels (sensitivity, specificity and under- or overestimation) of the emergency response centre's urgency assessment with the non-conveyance rate (%) of each dispatch category. The relationships between the variables were measured using Spearman's rank correlation coefficient.

Results: The proportion of over-triage was the only urgency assessment's test performance variable that had a statistically significant correlation with the proportion of non-conveyance (r = 0.568; p = 0.003). Other test performance variables of the urgency assessment had no or little correlation to the proportion of non-conveyance. Of the 6,416 EMS dispatches in the study period, 42% (2,672) resulted in non-conveyance of the patient. In nine dispatch categories, at least half (51-69%) of the dispatches ended in non-conveyance.

Conclusions: Based on this study, it seems that the percentage of non-conveyance in the dispatch category could be used, with certain limitations, to assess the proportion of over-triage in the dispatch category. The method is particularly applicable in scenarios where the dispatch criteria have undergone modifications and there is a need to monitor the effect of the changes on the level of over-triage.

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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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