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首页> 外文期刊>Prehospital emergency care >Repeat EMS transports among elderly emergency department patients.
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Repeat EMS transports among elderly emergency department patients.

机译：在老年急诊科患者之间重复EMS运输。

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OBJECTIVES: Previous studies of repeat care of the elderly have focused on trauma cases only. The purposes of this study were to identify repeat transports of elderly patients to the authors' emergency department (ED) by emergency medical services (EMS), to identify demographics, and to compare chief complaints. METHODS: A population-based, retrospective cohort study was conducted. Data for this study were obtained from computerized registration files in an urban, university-affiliated ED with an annual census of approximately 60,000 visits. Patients were included if they were 65 years of age or older and they were transported by EMS in 1997. The repeater group included patients who had one or more EMS transports within the following 12 months. The comparison group was composed of all patients with no further EMS transport within the 12 months after the index visit. Demographics extracted from the database were gender, chief complaint, total number of visits, and time since previous visits. Repeats were characterized by frequency (number of visits in 12 months after the index visit), type (visit for same vs different complaint), and rate (time to the first return visit). Repeaters were defined as more than one visit within a 12-month period. Repeaters were subdivided as follows: "immediate" (within 72 hours), "short-term" (within 2 months), and "long-term" (within 12 months). Chi-square and 95% confidence intervals (95% CIs) were used. A p-value < 0.05 was considered statistically significant. RESULTS: There were 365 (23%) repeaters and 1,212 (77%) nonrepeaters. Repeaters accounted for 811 (40%) of the total of 2,023 elderly patients transported by EMS. Fifty-seven percent of all elderly patients transported by EMS were female, with no significant difference between the repeaters and nonrepeaters. There were significantly fewer transports for a chief complaint of trauma among the repeaters than among the nonrepeaters (14% vs 26%, diff = 12, 95% CI = 9-15%). Among the 365 repeaters, 186 (51%) had two transports, 92 (15%) had three transports, 36 (10%) had four transports, and 51 (14%) had five or more transports. Of the return transports by repeaters, 40 (12%) were immediate, CONCLUSION: Repeaters accounted for 18% of elderly ED patients transported by EMS and 40% of elderly transports to the authors' ED. There were significantly fewer trauma transports in the repeater group. One-half of the repeaters returned only once in a 12-month period and a third of these occurred more than three months apart. It is important to understand the characteristics of elderly EMS repeaters in order to use this opportunity for intervention.
机译：目的：以前对老年人进行重复护理的研究仅关注创伤病例。这项研究的目的是确定通过急诊医疗服务（EMS）将老年患者重复运送到作者的急诊科（ED），确定人口统计数据并比较主要投诉。方法：进行了一项基于人群的回顾性队列研究。这项研究的数据来自城市附属大学教育署的计算机注册文件，每年人口普查约60,000次。年龄在65岁或65岁以上的患者被包括在内，并于1997年通过EMS转运。中继器组包括在接下来的12个月内进行一次或多次EMS转运的患者。比较组由所有在索引访视后12个月内没有进一步EMS转运的患者组成。从数据库中提取的人口统计信息包括性别，主要投诉，总访问次数以及自上次访问以来的时间。重复的频率，频率（索引访问后12个月内的访问次数），类型（相同或不同投诉的访问次数）和发生率（首次回访的时间）来表征。中继器的定义是在12个月内访问一次以上。中继器细分为：“立即”（72小时内），“短期”（2个月内）和“长期”（12个月内）。使用卡方和95％置信区间（95％CI）。 P值<0.05被认为具有统计学意义。结果：有365个（23％）中继器和1,212个（77％）非中继器。 EMS运送的2,023名老年患者中，中继器占811名（40％）。通过EMS运送的所有老年患者中有57％是女性，留级者和非留级者之间无显着差异。在转发器中，主要的主诉创伤明显少于非转发器（14％vs 26％，diff = 12，95％CI = 9-15％）。在365个中继器中，有186个（51％）有两个传输，有92个（15％）有三个传输，有36个（10％）有四个传输，有51个（14％）有五个或更多传输。结论：在由中继器返还的转运中，有40例（占12％）是立即送达的。结论：中继器占EMS转运的老年ED患者的18％，占提交人ED的老年转运的40％。直放站组的创伤运输明显减少。一半的中继器在12个月内仅返回一次，其中三分之一发生了三个月以上。重要的是要了解老年EMS中继器的特性，以便利用此机会进行干预。

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