Quantifying Dynamic Flow of Emergency Department (ED) Patient Managements: A Multistate Model Approach
المؤلفون المشاركون
Yen, Amy Ming-Fang
Tang, Petrus
Chaou, Chung-Hsien
Chiu, Te-Fa
Pan, Shin-Liang
Chang, Shu-Hui
Lai, Chao-Chih
Wang, Ruei-Fang
Chen, Hsiu-Hsi
المصدر
Emergency Medicine International
العدد
المجلد 2020، العدد 2020 (31 ديسمبر/كانون الأول 2020)، ص ص. 1-9، 9ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2020-12-07
دولة النشر
مصر
عدد الصفحات
9
التخصصات الرئيسية
الملخص EN
Background.
Emergency department (ED) crowding and prolonged lengths of stay continue to be important medical issues.
It is difficult to apply traditional methods to analyze multiple streams of the ED patient management process simultaneously.
The aim of this study was to develop a statistical model to delineate the dynamic patient flow within the ED and to analyze the effects of relevant factors on different patient movement rates.
Methods.
This study used a retrospective cohort available with electronic medical data.
Important time points and relevant covariates of all patients between January and December 2013 were collected.
A new five-state Markov model was constructed by an expert panel, including three intermediate states: triage, physician management, and observation room and two final states: admission and discharge.
A day was further divided into four six-hour periods to evaluate dynamics of patient movement over time.
Results.
A total of 149,468 patient records were analyzed with a median total length of stay being 2.12 (interquartile range = 6.51) hours.
The patient movement rates between states were estimated, and the effects of the age group and triage level on these movements were also measured.
Patients with lower acuity go home more quickly (relative rate (RR): 1.891, 95% CI: 1.881–1.900) but have to wait longer for physicians (RR: 0.962, 95% CI: 0.956–0.967) and admission beds (RR: 0.673, 95% CI: 0.666–0.679).
While older patients were seen more quickly by physicians (RR: 1.134, 95% CI: 1.131–1.139), they spent more time waiting for the final state (for admission RR: 0.830, 95% CI: 0.821–0.839; for discharge RR: 0.773, 95% CI: 0.769–0.776).
Comparing the differences in patient movement rates over a 24-hour day revealed that patients wait longer before seen by physicians during the evening and that they usually move from the ED to admission afternoon.
Predictive dynamic illustrations show that six hours after the patients’ entry, the probability of still in the ED system ranges from 28% in the evening to 38% in the morning.
Conclusions.
The five-state model well described the dynamic ED patient flow and analyzed the effects of relevant influential factors at different states.
The model can be used in similar medical settings or incorporate different important covariates to develop individually tailored approaches for the improvement of efficiency within the health professions.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Chaou, Chung-Hsien& Chiu, Te-Fa& Pan, Shin-Liang& Yen, Amy Ming-Fang& Chang, Shu-Hui& Tang, Petrus…[et al.]. 2020. Quantifying Dynamic Flow of Emergency Department (ED) Patient Managements: A Multistate Model Approach. Emergency Medicine International،Vol. 2020, no. 2020, pp.1-9.
https://search.emarefa.net/detail/BIM-1159002
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Chaou, Chung-Hsien…[et al.]. Quantifying Dynamic Flow of Emergency Department (ED) Patient Managements: A Multistate Model Approach. Emergency Medicine International No. 2020 (2020), pp.1-9.
https://search.emarefa.net/detail/BIM-1159002
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Chaou, Chung-Hsien& Chiu, Te-Fa& Pan, Shin-Liang& Yen, Amy Ming-Fang& Chang, Shu-Hui& Tang, Petrus…[et al.]. Quantifying Dynamic Flow of Emergency Department (ED) Patient Managements: A Multistate Model Approach. Emergency Medicine International. 2020. Vol. 2020, no. 2020, pp.1-9.
https://search.emarefa.net/detail/BIM-1159002
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1159002
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر