多维急诊科拥挤评分量表编制  

Drawing up multidimensional emergency medicine overcrowding scale

作　　者：徐腾达[1] 于学忠[2] 沈洪[3] 周荣斌[4] 陈旭岩[5] 郭树彬[6] 徐军[2] 张晖[2] 李涛[7] 

机构地区：[1]北京协和医院健康医学部,急诊科,北京100730 [2]北京协和医院急诊科,北京100730 [3]中国人民解放军总医院急诊科,北京100853 [4]北京军区总医院急诊科,北京100026 [5]清华大学长庚医院急诊科,北京102218 [6]首都医科大学附属北京朝阳医院急诊科,北京100020 [7]北京协和医院心理医学科,北京100730

出　　处：《中华急诊医学杂志》2016年第6期814-819,共6页Chinese Journal of Emergency Medicine

摘　　要：目的通过对急诊科拥挤相关变量筛选，共纳入急诊总床位占用率、抢救室床位占用率、廊厅／过道诊治患者数、候诊患者数量和时间、正在使用的生命脏器功能支持设备数量、新进抢救室病例数、ICU满负荷状况、急诊满负荷状况（持续时间）、流出道梗阻率、救护车转向和LWBS现象等12项易在中国城市医院急诊科获得的有效的拥挤相关指标，并对之进行赋值，依据RobertF．DeVellis等编著的量表编制指南，构建新的多维急诊科拥挤评分量表（MEDOS，系统得分范围0～40分）。随后进行为期6个月量表测试，初步研究结果显示，MEDOS均值（n=552）为25．4±5．8（5～39），90百分位数为34分，75百分位数为31分，中位数为26分，25百分位数为21分，10百分位数为17分。折半信度检验MEDOS内部一致性，Split—half系数为0．817（P〈0．01），提示MEDOS量表评分法有良好的可信度。Objective The assessment of ED （emergency medicine ） crowding is one of the most challenging issues and the rewarding aspects of ED management in the last decade. The relevant physicians in China developed a new approach of ED crowding measurement, and they selected the 32 widely used and accessible indicators of ED crowding in the local as candidates by means of repeated sifting. Of them, 12 variables, such as the occupancies of ED bed and total ED-based critic care bed, the number of patients in corridor and waiting room, the number of fresh patients send to critic care in last 2 hours, the usage of life- support equipments, access block rates, the frequency of ambulance diversion and patients leave without bing seen （LWBS） were selected as options to edit the Muhidimensional ED Overcrowding Scale （MEDOS） followed by guidelines in scale development （Robert F. DeVellis） . Clearly, the validity and reliability of the MEDOS remain to be further studied.

关 键 词：急诊科 拥挤 测量 多维急诊科拥挤评分量表 中国 

分 类 号：R459.7[医药卫生—急诊医学]