虚拟云结算联合无陪护诊疗模式在急诊危重症患者中的应用  

Application of virtual cloud billing combined with unaccompanied new diagnosis and treatment model in emergency critically ill patients

作　　者：王钰炜[1] 刘亚洁 高彬炳 方珏 王萍[1] 丁建波[2] 张涛[3] 袁咏梅 李吉辉[5] 王飒[1] WANG Yuwei;LIU Yajie;GAO Binbing;FANG Jue;WANG Ping;DING Jianbo;ZHANG Tao;YUAN Yongmei;LI Jihui;WANG Sa

机构地区：[1]浙江大学医学院附属第二医院护理部,杭州市310009 [2]浙江大学医学院附属第二医院急诊医学科,杭州市310009 [3]浙江大学医学院附属第二医院医务部,杭州市310009 [4]浙江大学医学院附属第二医院财务科,杭州市310009 [5]浙江大学医学院附属第二医院信息中心,杭州市310009

出　　处：《中华急危重症护理杂志》2025年第2期188-194,共7页Chinese Journal of Emergency and Critical Care Nursing

基　　金：浙江省卫生厅基金资助项目(2022KY175)。

摘　　要：目的探讨虚拟云结算联合无陪护诊疗模式在急诊危重症患者管理中的应用效果。方法浙江省某三级甲等综合医院急诊抢救室自2021年1月起实施跨学科多部门合作创立的诊疗模式,并进行持续优化。回顾性分析2020年1月—2023年12月36551例患者的诊疗数据,按照诊疗模式的不同阶段分组比较:传统期(2020年,n=6931)、新模式探索期(2021年,n=8501)、新模式完善期(2022年,n=10095)及新模式稳定期(2023年,n=11024)。对各组间抢救室停留时间、血化验送检时间、用药等候时间、CT等候时间、缴费结算总次数及欠款总例次进行统计分析。结果各时期之间抢救室停留时间、血化验送检时间、用药等候时间、CT等候时间及缴费结算总次数差异均具有统计学意义(P<0.001),各组间欠款总例次差异不具有统计学意义(P=0.998)。结论该诊疗模式的创建对提高急诊抢救室患者精细化护理管理、改善就医体验具有重要意义。Objective To explore the application effectiveness of a new diagnostic and treatment model combining virtual cloud billing with unaccompanied care in the management of critically ill emergency patients.Methods Starting from January 2021,a new treatment model involving interdisciplinary and multi-department cooperation was implemented and continuously optimized in the emergency rescue room of a tertiary class A hospital in Zhejiang Province.This retrospective study analyzed the treatment data of 36551 patients from January 2020 to December 2023.The patients were grouped according to different stages of the treatment model,including traditional period(2020,n=6931),new model exploration period(2021,n=8501),new model improvement period(2022,n=10095),new model stabilization period(2023,n=11024).Statistical analysis was conducted on the differences in emergency room stay time,blood test waiting time,medication waiting time,CT scan waiting time,total number of billing settlements and total instances of outstanding payments among the groups.Results There were statistically significant differences among the periods in terms of emergency room stay time,blood test waiting time,medication waiting time,CT scan waiting time,and total number of billing settlements(P<0.001).There was no significant difference in the total instances of outstanding payments among the groups(P=0.998).Conclusion The establishment of this new diagnostic and treatment model is of great significance in improving the refined management of patients in emergency rescue room and enhancing the medical experience.

关 键 词：急诊室 数智驱动 无陪护 医疗护理员 护理管理研究 

分 类 号：R472.2[医药卫生—急诊医学]