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首页> 外文期刊>Prehospital emergency care >EMS-STARS: EMERGENCY MEDICAL SERVICES 'SUPERUSER' TRANSPORT ASSOCIATIONS: AN ADULT RETROSPECTIVE STUDY
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EMS-STARS: EMERGENCY MEDICAL SERVICES 'SUPERUSER' TRANSPORT ASSOCIATIONS: AN ADULT RETROSPECTIVE STUDY

机译：EMS-STARS：紧急医疗服务“超级用户”运输协会：成人回顾性研究

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Objective. Emergency medical services (EMS) "superusers" - those who use EMS services at extremely high rates - have not been well characterized. Recent interest in the small group of individuals who account for a disproportionate share of health-care expenditures has led to research on frequent users of emergency departments and other health services, but little research has been done regarding those who use EMS services. To inform policy and intervention implementation, we undertook a descriptive analysis of EMS superusers in a large urban community. In this paper we compare EMS superusers to low, moderate, and high users to characterize factors contributing to EMS use. We also estimate the financial impact of EMS superusers. Methods. We conducted a retrospective cross-sectional study based on 1 year of data from an urban EMS system. Data for all EMS encounters with patients age >= 18 years were extracted from electronic records generated on scene by paramedics. We identified demographic and clinical variables associated with levels of EMS use. EMS users were characterized by the annual number of EMS encounters: low (1), moderate (2-4), high (5-14), and superusers (>= 15). In addition, we performed a financial analysis using San Francisco Fire Department (SFFD) 2009 charge and reimbursement data. Results. A total of 31,462 adults generated 43,559 EMS ambulance encounters, which resulted in 39,107 transports (a 90% transport rate). Encounters for general medical reasons were common among moderate and high users and less frequent among superusers and low users, while alcohol use was exponentially correlated with encounter frequency. Superusers were significantly younger than moderate EMS users, and more likely to be male. The superuser group created a significantly higher financial burden/person than any other group, comprising 0.3% of the study population, but over 6% of annual EMS charges and reimbursements. Conclusions. In this retrospective study, adult EMS "superusers" emerged as a distinct, predominantly male population and their EMS encounters were associated with alcohol use. Continued analysis of this unique, high-cost, and frequently transported population will likely illuminate specific intervention strategies.
机译：目的。紧急医疗服务（EMS）的“超级用户”（即以极高的比率使用EMS服务的用户）的特征尚未明确。最近，对一小部分在医疗保健支出中所占比例不成比例的人产生了兴趣，这导致人们对急诊部门和其他医疗服务的经常使用者进行了研究，但对于使用EMS服务的人却鲜有研究。为了指导政策和干预措施的实施，我们对大型城市社区中的EMS超级用户进行了描述性分析。在本文中，我们将EMS超级用户与低，中和高用户进行比较，以表征促成EMS使用的因素。我们还估计了EMS超级用户的财务影响。方法。我们基于1年的城市EMS系统数据进行了回顾性横断面研究。从医护人员在现场生成的电子记录中提取所有年龄大于等于18岁的EMS的数据。我们确定了与EMS使用水平相关的人口统计学和临床​​变量。 EMS用户的特点是每年遇到EMS：低（1），中（2-4），高（5-14）和超级用户（> = 15）。另外，我们使用了旧金山消防局（SFFD）2009的收费和报销数据进行了财务分析。结果。共有31,462名成年人产生了43,559次EMS救护车，导致39,107次运输（运输率90％）。由于一般的医学原因，count症在中度和高度人群中很常见，而在高度人群和低度人群中较少见，而饮酒与遭遇频率呈指数相关。超级用户比中度EMS用户要年轻得多，并且更有可能是男性。超级用户组造成的经济负担/人均比任何其他组都要高得多，占研究人口的0.3％，但超过每年EMS费用和偿还额的6％。结论。在这项回顾性研究中，成人EMS“超级用户”以明显的男性人群为主，他们的EMS遭遇与饮酒有关。对这种独特的，高成本的和经常运输的人群的持续分析可能会阐明特定的干预策略。

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