“新型冠状病毒肺炎”疫情下某三级综合医院急诊患者就诊特点与急诊管理思考  

Characteristics of emergency patients in a tertiary general hospital under the“novel coronavirus”epidemic and thinking on emergency management

作　　者：刘颖[1] 沈君华[1] 张云[1] 王芳[1] Liu Ying;Shen Junhua;Zhang Yun;Wang Fang(Emergency Department,Nantong First People's Hospital,Nantong 226001,China)

机构地区：[1]南通市第一人民医院急诊科,江苏南通226001

出　　处：《中华卫生应急电子杂志》2021年第6期342-345,共4页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：2020年南通市科技计划新型冠状病毒科研攻关项目(XG202001-3)。

摘　　要：目的分析"新型冠状病毒肺炎(COVID-19)"疫情影响下,急诊患者就诊特点的变化,探索未来急诊医疗需求的变化趋势,为急诊资源合理调配、急诊救治研究方向确立及医务人员培训等提供依据。方法采用回顾性列队研究方法,比较南通市第一人民医院2019年1月至7月疫情前组和2020年1月至7月疫情期间组急诊患者数量、病种和病情分级构成、疫情前和疫情期间两组时间内护理人力资源分配数据的变化。结果急诊患者总量疫情前组103033例,疫情期间组68575例。内科系统疾病就诊占比显著下降,外科系统疾病就诊比例显著上升(均P<0.001)。与疫情前组相比,疫情期间组内科系统中,呼吸系统、环境伤害疾病占比显著下降(均P<0.001);外科系统中,泌尿系统、血管系统及外伤占比显著增加(均P<0.001)。一、二级患者中,疫情期间组内科系统疾病占比明显增加,而外科系统占比明显减少(P<0.05),严重创伤疫情期间组占比下降明显(P<0.05)。疫情前组护理总班次6177,疫情期间组护理总班次7499。疫情期间预检班次比占显著增加(P<0.001);助诊班次设置显著减少(P<0.001)。结论COVID-19疫情下急诊患者就诊特点能反映本地区真正的急诊需求,仍以内科系统的呼吸、心血管、神经和消化系统专科以及外科的创伤救治为主要需求;对三级综合医院今后急诊专科发展、重点培训方向、人力资源调配和急诊大数据建设具有一定参考价值。Objective To analyze the changes of emergency patients’visiting characteristics under the influence of“novel coronavirus-19(COVID-19)”epidemic,to explore the changing trend of emergency medical demand in the future,and to provide the basis for rational allocation of emergency resources,establishment of emergency treatment research direction and training of medical staff.Methods A retrospective cohort study method was used to compare the number of emergency patients,the composition of disease types and disease grades,and the changes of nursing human resource allocation data before and during the epidemic in Nantong First People’s Hospital from January to July 2019 to January to July 2020.Results The total number of emergency patients was 103033 before the epidemic and 68575 during the epidemic.The proportion of visits for medical diseases decreased significantly,while that for surgical diseases increased significantly(all P<0.001).Compared with the pre-epidemic group,the proportion of respiratory diseases and environmental injuries in the internal medicine system of the epidemic group decreased significantly(all P<0.001).In the surgical system,urinary system,vascular system and trauma increased significantly(all P<0.001).Among the first and second grade patients,the proportion of diseases in the internal medicine system increased significantly during the epidemic period,while that in the surgical system decreased significantly(P<0.05),while that in the severe trauma during the epidemic decreased significantly(P<0.05).The total number of nursing shifts in the group before the epidemic was 6177,and that in the group during the epidemic was 7499.During the period,the frequency of pre-inspection of epidemic situation increased significantly(P<0.001);The number of visiting shifts was significantly reduced(P<0.001).Conclusion The characteristics of emergency patients under COVID-19 epidemic can reflect the real emergency needs in this area,and the main needs are respiratory,cardiovascular,neurological and digest

关 键 词：新型冠状病毒肺炎 急诊患者就诊特点 急诊管理 

分 类 号：R197.32[医药卫生—卫生事业管理]