دورية أكاديمية
أعرض في EDS

The Impact of Ambulance and Patient Diversion on Crowdedness of Multiple Emergency Departments in a Region.

التفاصيل البيبلوغرافية
العنوان: The Impact of Ambulance and Patient Diversion on Crowdedness of Multiple Emergency Departments in a Region.
المؤلفون: Kao CY; Department of Electrical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan., Yang JC; Department of Electrical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan., Lin CH; Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
المصدر: PloS one [PLoS One] 2015 Dec 11; Vol. 10 (12), pp. e0144227. Date of Electronic Publication: 2015 Dec 11 (Print Publication: 2015).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Ambulance Diversion* , Ambulances* , Crowding* , Emergency Service, Hospital* , Hospitals*, Computer Simulation ; Humans ; Taiwan
مستخلص: Emergency department (ED) overcrowding threatens healthcare quality. Ambulance diversion (AD) may relieve ED overcrowding; however, diverting patients from an overcrowded ED will load neighboring EDs with more patients and may result in regional overcrowding. The purpose of this study was to evaluate the impact of different diversion strategies on the crowdedness of multiple EDs in a region. The importance of regional coordination was also explored. A queuing model for patient flow was utilized to develop a computer program for simulating AD among EDs in a region. Key parameters, including patient arrival rates, percentages of patients of different acuity levels, percentage of patients transported by ambulance, and total resources of EDs, were assigned based on real data. The crowdedness indices of each ED and the regional crowdedness index were assessed to evaluate the effectiveness of various AD strategies. Diverting patients equally to all other EDs in a region is better than diverting patients only to EDs with more resources. The effect of diverting all ambulance-transported patients is similar to that of diverting only low-acuity patients. To minimize regional crowdedness, ambulatory patients should be sent to proper EDs when AD is initiated. Based on a queuing model with parameters calibrated by real data, patient flows of EDs in a region were simulated by a computer program. From a regional point of view, randomly diverting ambulatory patients provides almost no benefit. With regards to minimizing the crowdedness of the whole region, the most promising strategy is to divert all patients equally to all other EDs that are not already crowded. This result implies that communication and coordination among regional hospitals are crucial to relieve overall crowdedness. A regional coordination center may prioritize AD strategies to optimize ED utility.
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تواريخ الأحداث: Date Created: 20151215 Date Completed: 20160627 Latest Revision: 20190222
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC4684360
DOI: 10.1371/journal.pone.0144227
PMID: 26659589
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0144227