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首页> 外文期刊>JMIR mHealth and uHealth >Improvements in Patient Acceptance by Hospitals Following the Introduction of a Smartphone App for the Emergency Medical Service System: A Population-Based Before-and-After Observational Study in Osaka City, Japan
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Improvements in Patient Acceptance by Hospitals Following the Introduction of a Smartphone App for the Emergency Medical Service System: A Population-Based Before-and-After Observational Study in Osaka City, Japan

机译：在为紧急医疗服务系统引入智能手机应用程序之后，医院对患者的接受程度有所提高：在日本大阪市进行的基于人口的前后观察研究

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Background Recently, the number of ambulance dispatches has been increasing in Japan, and it is therefore difficult for hospitals to accept emergency patients smoothly and appropriately because of the limited hospital capacity. To facilitate the process of requesting patient transport and hospital acceptance, an emergency information system using information technology (IT) has been built and introduced in various communities. However, its effectiveness has not been thoroughly revealed. We introduced a smartphone app system in 2013 that enables emergency medical service (EMS) personnel to share information among themselves regarding on-scene ambulances and the hospital situation. Objective The aim of this study was to assess the effects of introducing this smartphone app on the EMS system in Osaka City, Japan. Methods This retrospective study analyzed the population-based ambulance records of Osaka Municipal Fire Department. The study period was 6 years, from January 1, 2010 to December 31, 2015. We enrolled emergency patients for whom on-scene EMS personnel conducted hospital selection. The main endpoint was the difficulty experienced in gaining hospital acceptance at the scene. The definition of difficulty was making ≥5 phone calls by EMS personnel at the scene to hospitals until a decision to transport was determined. The smartphone app was introduced in January 2013, and we compared the patients treated from 2010 to 2012 (control group) with those treated from 2013 to 2015 (smartphone app group) using an interrupted time-series analysis to assess the effects of introducing this smartphone app. Results A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 emergency patients in the control group (50.00%, 300,313/600,526) from 2010 to 2012 and 300,395 emergency patients in the smartphone app group (50.00%, 300,395/600,526) from 2013 to 2015. The rate of difficulty in hospital acceptance was 14.19% (42,585/300,131) in the control group and 10.93% (32,819/300,395) in the smartphone app group. No change over time in the number of difficulties in hospital acceptance was found before the introduction of the smartphone app (regression coefficient: ?2.43, 95% CI ?5.49 to 0.64), but after its introduction, the number of difficulties in hospital acceptance gradually decreased by month (regression coefficient: ?11.61, 95% CI ?14.57 to ?8.65). Conclusions Sharing information between an ambulance and a hospital by using the smartphone app at the scene was associated with decreased difficulty in obtaining hospital acceptance. Our app and findings may be worth considering in other areas of the world where emergency medical information systems with IT are needed.
机译：背景技术近年来，在日本，急救车的派遣数量不断增加，由于医院的能力有限，医院难以顺利，适当地接受急诊病人。为了促进请求患者运输和医院接受的过程，已经建立了使用信息技术（IT）的紧急信息系统，并将其引入各个社区。但是，其有效性尚未完全揭示。我们在2013年推出了智能手机应用程序系统，使急诊医疗服务（EMS）人员可以在彼此之间共享有关现场救护车和医院情况的信息。目的这项研究的目的是评估在日本大阪市将此智能手机应用程序引入EMS系统的效果。方法这项回顾性研究分析了大阪市消防局基于人群的救护车记录。研究期限为6年，从2010年1月1日至2015年12月31日。我们招募了急诊患者，由急诊EMS人员进行了医院选择。主要终点是在现场获得医院认可所遇到的困难。困难的定义是现场的EMS人员拨打≥5次电话到医院，直到确定运输决定为止。该智能手机应用程序于2013年1月推出，我们使用中断时间序列分析来比较2010年至2012年（对照组）与2013年至2015年（智能手机应用程序组）治疗的患者，以评估该智能手机的引入效果应用程式。结果EMS人员选择医院的600526名急诊患者符合我们的分析要求。从2010年至2012年，对照组中有300,131名急诊患者（50.00％，300,313 / 600,526），从2013年至2015年，智能手机应用程序组中有300,395名急诊患者（50.00％，300,395 / 600,526）。住院接受的困难率对照组为14.19％（42,585 / 300,131），智能手机应用程序组为10.93％（32,819 / 300,395）。在引入智能手机应用程序之前，医院验收的困难数量没有随时间变化（回归系数：？2.43，95％CI？5.49至0.64），但是在引入之后，医院验收的困难数量逐渐增加下降了一个月（回归系数：？11.61，95％CI？14.57至？8.65）。结论在现场使用智能手机应用程序在救护车和医院之间共享信息与减少医院接受的难度有关。我们的应用程序和发现可能在世界其他需要IT紧急医疗信息系统的地区值得考虑。

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