Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center

응급의료센터 내원환자 진료시 소요시간과 관련된 요인

  • Han, Nam Sook (Department of Nursing, Yeungnam University Hospital) ;
  • Park, Jae Yong (Graduate School of Public Health, Kyungpook National University) ;
  • Lee, Sam Beom (Department of Emergency Medicine, College of Medicine, Yeungnam University) ;
  • Do, Byung Soo (Department of Preventive Medicine, College of Medicine, Yeungnam University) ;
  • Kim, Seok Beom (Department of Preventive Medicine, College of Medicine, Yeungnam University)
  • 한남숙 (영남대학교병원 간호부) ;
  • 박재용 (경북대학교 보건대학원) ;
  • 이삼범 (영남대학교 의과대학 응급의학교실) ;
  • 도병수 (영남대학교 의과대학 예방의학교실) ;
  • 김석범 (영남대학교 의과대학 예방의학교실)
  • Published : 2000.12.30

Abstract

Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.