基于断点回归设计分析应急处理对重庆市120急救调度的影响  

Impact analysis of emergency intervention on 120 ambulance dispatchers in Chongqing city with regression discontinuity designs

作　　者：陈波 余海燕[2,3] 左小龙 Chen Bo;Yu Haiyan;Zuo Xiaolong(Chongqing Emergency Medical Center,Chongqing University Central Hospital,Chongqing,400014;School of Economics and Management,Chongqing University of Posts and Telecommunications,Chongqing,404615;Key Laboratory of Big Data Intelligent Computing,Chongqing University of Posts and Telecommunications,Chongqing 404615)

机构地区：[1]重庆市急救医疗中心/重庆大学附属中心医院,重庆400014 [2]重庆邮电大学经济管理学院,重庆400060 [3]重庆邮电大学大数据智能计算重点实验室,重庆400060

出　　处：《中华急诊医学杂志》2024年第3期421-425,共5页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金面上项目(62272077);重庆市技术创新与应用发展专项重点项目(CSTB2022TIAD-KPX0155);重庆市科卫联合医学科研项目重大项目(2023DBXM008);重庆市自然科学基金面上项目(CSTB2023NSCQ-MSX0073);重庆市教委科学技术研究项目(KJQN202200608)。

摘　　要：目的探究突发公共卫生事件应急处理对院前急救工作效率产生的重要影响,研究应急处理前后对重庆市120急救调度的影响程度。方法将120电话接听和车辆运行效率作为研究对象,收集重庆市急救医疗中心的院前急救数据,时间范围为2021年11月10日至2023年1月6日。按照应急处理相关时间分组,采用断点回归设计方法在同一期间进行对照比较,即实施应急处理的真实值与没有实施应急处理的预测值(虚拟)比较,推理出应急处理的平均干预效应。结果在间隔为27 d的研究时间段内,120电话接听的10 s内摘机数量从11000升至19000,但10 s内接听率略有下降;应急处理期间的120急救空车率从0.39%降低到0.20%,但18 min内的完成率从72%降低到了30%;在特殊的应急处理期间,相应的患者主诉数量(如高热和呼吸困难)较应急处理前有明显增加。结论应急处理对院前急救工作如急救电话接听和车辆运行效率等产生了重要影响,本研究为城市急救医疗服务应对突发公共卫生事件提供实证结果和决策支持。Objective To explore the impact of emergency response to public health emergencies on the efficiency of pre-hospital emergency work,and study the degree of impact on 120 ambulance dispatchers in Chongqing city during pre-periods and post-periods of the emergency intervention.Methods Taking 120 phone answering and ambulance operation efficiency as the research subjects,we collected pre-hospital emergency case data from a city's emergency medical center,covering the period from November 10,2021 to January 6,2023.The cases were divided into groups according to the time periods of emergency response.A regression discontinuity design method was employed to compare the response of emergency intervention to the predictions(virtual cases)without the emergency intervention,obtaining the average intervention effect.Results During the study period of 27 days,the number of 120 calls picked up within 10 seconds increased from 11000 to 19000,but the answering rate slightly decreased within 10 seconds.The vacancy rate of 120 ambulances during emergency response decreased from 0.39%to 0.20%,but the completion rate within 18 minutes decreased from 72%to 30%.In this particular emergency response period,the number of patient complaints(such as high fever and difficulty breathing)increased compared to the pre-period of emergency response.Conclusion Emergency response significantly impacts pre-hospital emergency work such as emergency phone answering and ambulance operation efficiency.This study provides empirical research results and decision-making support for urban emergency medical services to respond to public health emergencies.

关 键 词：院前急救 120调度 应急处理 断点回归设计 患者主诉 

分 类 号：R459.7[医药卫生—急诊医学]