Investigation on coping strategies for the increases of patients from emergency department in tertiary hospitals in China

MA Li; YU Miao; LI Baohua; MA Qingbian; GE Baolan; GE Hongxia; DU Lanfang

doi:10.12102/j.issn.1009-6493.2024.14.013

Abstract：Objective:To understand coping strategies for the increases of patients from emergency department in tertiary hospitals in China.Methods:Emergency departments from 54 tertiary hospitals in China were selected as the research subjects From January to March 2023.Among them,26 hospitals(48.1%)in the eastern region,10 hospitals(18.5%)in the central region,and 18 hospitals(33.3%)in the western region.A survey was conducted by a self-designed questionnaire on coping strategies for the increases of patients from emergency department in hospitals in different regions of China.Results:After increasing of patients from emergency department in tertiary hospitals,the daily average emergency volume increased by 87.5%,and the overall waiting time for emergency treatment was extended(Z=-5.560,P<0.001).The proportion of patients leaving the emergency room 72 hours after increased of patients from emergency department in tertiary hospitals in the eastern region decreased compared to before(P<0.05).In the context of increases of patients from emergency department,the response measures taken by the tertiary hospitals included increasing the number of emergency beds and the number of visiting doctors,adding wards dedicated to the treatment of patients with COVID-19,increasing investments in important equipment,and deploying medical staff to support emergency and so on.The change rate of emergency waiting time in tertiary hospitals in eastern region were negatively correlated with the change rate of doctor-patient ratio(r=-0.418,P=0.034),the change rate of nurse-patient ratio(r=-0.469,P=0.016),and the change rate of Internet diagnosis and treatment(r=-0.684,P=0.020).The change rate of retention time in emergency rooms in tertiary hospitals in eastern region was negatively correlated with the change rate of nurse-patient ratio(r=-0.422,P=0.032).The change rate of retention time in emergency rooms in tertiary hospitals in central and western regions was positively correlated with the change rate of observation room beds(r=0.405,P=0.036).Conclusions:The emergency department should constantly optimize the allocation of medical resources such as manpower,beds,instruments and equipments,it also should explore the new"Internet+"model for critical patients,and further improve the ability to cope with major infectious diseases.