[德国创伤中心的创伤室工作量:改革中创伤护理不足的现实]。

Cora R Schindler, Florian Pavlu, Philipp Faul, Philipp Störmann, Dan Bieler, Uwe Schweigkofler
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摘要

2018年4月,联邦联合委员会(G-BA)发布了一项关于医院应急结构分阶段系统的规定(根据《社会保障法V》),从而为住院部门的紧急护理奠定了基础。对可能严重受伤的病人的护理的结构要求主要是由专科医师协会确定的,这意味着要提供大量的人员,同时由于病人数量的增加,每年的负担也在增加。批评人士担心,改革没有充分考虑到创伤护理的专业和财务状况。本研究的目的是记录德国创伤中心急诊室的实际工作量。方法:在德国619家经德国创伤外科学会(DGU®)认证的创伤中心进行了一项全国性的在线调查,以量化创伤室呼叫的频率。将结果与创伤登记(TR) DGU®从2021年到2022年的年度报告数据进行回顾性比较。结果:167家参与调查的医院在2021年和2022年分别报告了22479次和24366次创伤室就诊情况(在线调查的回复率为24.1%)。在这些呼叫中,70%涉及一级跨区域创伤中心。对比分析表明,实际的标注数量比TR-DGU®中记录的数据高3-5倍。在创伤室中,80%因损伤严重程度低而未被纳入登记。该研究证实了德国创伤中心创伤室的记录工作量与实际工作量之间的差异,并强调有必要根据实际使用情况调整创伤中心的财务和人员考虑,以确保持续的高质量护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Trauma room workload in German trauma centers : Reality of trauma care underrepresented in reform].

Introduction: The Federal Joint Committee (G-BA) published a regulation on a staged system for emergency structures in hospitals (according to Social Security Code V) in April 2018 and therefore established the foundations for emergency care in the inpatient sector. The structural requirements for the care of potentially severely injured patients is primarily defined by the specialist society and means a high provision of personnel with a simultaneous annual increase in the burden due to increasing numbers of patients. Critics fear that the reforms do not take sufficient account of trauma care both professionally and financially. The aim of the study was to record the actual workload of the emergency trauma rooms in certified German trauma centers.

Method: A nationwide online survey was performed in Germany among 619 trauma centers certified by the German Society for Trauma Surgery (DGU®) to quantify the frequency of trauma room callouts. The results were retrospectively compared with the data from the annual reports of the TraumaRegister (TR) DGU® from 2021 and 2022.

Results: The 167 participating hospitals reported 22,479 trauma room callouts in 2021 and 24,366 in 2022 (response rate of the online survey 24.1%). Of these callouts 70% concerned level 1 supraregional trauma centers. The comparative analysis showed that the actual number of callouts is 3-5 times higher than the data documented in the TR-DGU® . Of the trauma rooms 80% were not included in the register due to low injury severity. The study confirms the discrepancy between the documented and actual workload of the trauma rooms in German trauma centers and emphasizes the necessity to adjust the financial and personnel consideration of the trauma centers to the actual utilization in order to ensure a continuing high quality of care.

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