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Probabilistic linkage of computerized ambulance and inpatient hospital discharge records: A potential tool for evaluation of emergency medical services

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ANNALS OF EMERGENCY MEDICINE 2001年第6期37卷 616-626页

作者： Dean, JM Vernon, DD Cook, L Nechodom, P Reading, J Suruda, A Univ Utah Sch Med Dept Pediat Intermt Injury Control Res Ctr Salt Lake City UT USA Univ Utah Sch Med Dept Family & Prevent Med Intermt Injury Control Res Ctr Salt Lake City UT USA

Study objectives: Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information is not available in out-of-hospital databases. We used probabilistic linkage to create such a database from ambulance and inpatient data and demonstrate the potential for linkage to facilitate evaluation of EMS responses resulting in hospital admission. Methods: Statewide ambulance and inpatient hospital discharge records were available for 1994 through 1946. Ambulance records indicating admission to the emergency department or hospital (165,649 records) were linked to inpatient hospital records indicating emergency admission (146,292 records) by using probabilistic linkage. Out-of-hospital data (dispatch code, treatments rendered, and ages), linkage rates, and inpatient data (discharge status, charges, length of stay, and payer category) were analyzed. Results: We linked 24,299 (14.7%) ambulance events to inpatient hospital discharges. If we had used exact linkage methods, we would have only linked 14,621 record pairs, a loss of nearly 40%. linkage rates were relatively constant between years (approximately 15%) but differed by ambulance dispatch codes. Out-of-hospital dispatch codes with high linkage rates included breathing problems (22.6%), chest pain (21.5%), diabetic problems (16.9%), drowning incidents (14.9%), falls (19.2%), strokes (32.8%), and unconsciousness or fainting episodes (16.1%). Linkage to the hospital record provided access to hospital outcome data. Inpatient mortality was 6.8%. Survivors were discharged home (60.7%), transferred to other acute-care facilities (3.6%) or intermediate-care facilities (23.3%), or discharged with home health care provision (4.9%). The median length of stay was 3 days, and median charges were $6,620;total inpatient charges were $286,737,067. Conclusion: Probabilistic linkage enables ambulance and hospita

关键词：救护车/组织和管理数据库管理系统可行性研究卫生服务研究/方法医院收费/统计学和数值数据医院死亡率信息系统/组织和管理住院病人/统计学和数值数据保险健康/统计学和数值数据住院时间/统计学和数值数据病案连锁/方法病案系统计算机化/组织和管理年患病率结果评价(卫生保健) 病人出院/统计学和数值数据病人转诊/统计学和数值数据概率存活率分析犹他/流行病学青少年成年人老年人老年人 80以上儿童儿童学龄前女(雌)性人类婴儿男(雄)性中年人

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抢救车管理存在问题及对策

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中国误诊学杂志 2008年第26期8卷 6400-6401页

作者：吴华颖田家香蔡素玲珠海中山大学附属第五医院老年病科 519000

目的:探讨抢救车管理方法。方法:完善三级护理质量控制,统一设置急救物品、药品放置示意图、药品有效期一览表;抢救车封条管理。结果:急救物品完好率由原来的平均92.3%上升为100%,患者满意度由原来的平均95.6%上升为98.2%。结论:抢救车... 详细信息

目的:探讨抢救车管理方法。方法:完善三级护理质量控制,统一设置急救物品、药品放置示意图、药品有效期一览表;抢救车封条管理。结果:急救物品完好率由原来的平均92.3%上升为100%,患者满意度由原来的平均95.6%上升为98.2%。结论:抢救车的三级质量控制,规范化、封条管理模式,方便抢救、节省时间、提高了急救物品管理质量及患者满意度。

关键词：救护车/组织和管理

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How do ambulance personnel experience work at a disaster site?

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Accident and Emergency Nursing 2001年第2期9卷 56-66页

作者： Suserud, Bjorn-Ove Borås University College School of Health Sciences Kunskapscentrum PreHospen 501 90 Borås Sweden

Working at a major accident site is a complex matter where knowledge from various fields must be put into practice. In addition, the different situations at emergency and disaster sites place a variety of demands on personnel, equipment and organization. The aim of the present study is to investigate how the ambulance personnel perceived their own action and the functioning of the whole emergency organization at a major accident site (large discotheque fire) in 1998. Working from a list obtained from the fire department, a questionnaire with 57 questions was sent to the personnel (n = 36) who had participated at the accident site either as ambulance crew members or as members of a medical team sent out from the hospital. The response rate was 80 per cent. Despite the extreme situation, most of the ambulance personnel involved were satisfied with their own preparedness as well as the medical and nursing care performed at the site. Those who where not satisfied reported that the main reason for dissatisfaction was lack of time to calm and comfort people who were not injured or had only minor injuries. The need of more medical support for the medical team members at the site was also emphasized with regard to the care of the severely injured. The ambulance service crews from the suburbs, in comparison with the local city rescue service, were, in general, less satisfied with the co-operation from other rescue units. © 2001 Harcourt Publishers Ltd.

关键词：救护车/组织和管理医务工作者的态度救灾计划/组织和管理急救技师/心理学火灾机构间关系卫生保健质量救援作业/组织和管理瑞典成年人女(雌)性人类男(雄)性中年人

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抢救车系统管理模式在护理工作中的应用

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中国误诊学杂志 2009年第8期9卷 1855-1856页

作者：曹春雅张晓春顾玉花江苏省昆山市第三人民医院骨科 215316

抢救成功率是体现一个医院医疗技术水平的有效指标之一,而对抢救物品、器械的有效管理是提高抢救成功率的可靠保证,也是护理管理工作的重点之一。而抢救药品、物品大部分都集中在抢救车,因此,科室内抢救车的管理显得尤为重要。以往我们... 详细信息

抢救成功率是体现一个医院医疗技术水平的有效指标之一,而对抢救物品、器械的有效管理是提高抢救成功率的可靠保证,也是护理管理工作的重点之一。而抢救药品、物品大部分都集中在抢救车,因此,科室内抢救车的管理显得尤为重要。以往我们每天对抢救车进行班班交接,显得费时费力,又不能做到抢救车药械完好率100%。结合我科工作实际,同时借鉴其他医院的管理方法,对我科抢救车的管理方法进行了改革,不仅采用封条式管理,而且形成了一整套系统的管理模式,确保抢救药品、物品保质保量,在抢救时可以做到方便、快捷、准确、及时,收到很好的效果,现总结如下。[第一段]

关键词：救护车/组织和管理护理工作/组织和管理

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Implementing paramedic thrombolysis - An overview

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Accident and Emergency Nursing 2002年第4期10卷 189-196页

作者： Quinn, Tom Butters, Andrew Todd, Ian School of Health and Social Sciences Coventry University Coventry CV1 5FB United Kingdom Warwickshire Ambulance Service NHS Trust Warwickshire CV 32 5HH Dale Street United Kingdom Trust Management Office Warwick Hospital Warwick CV 34 5BW Lakin Road United Kingdom

The UK Government has made improvements in cardiac care a high priority. The publication in 2000 of the National Service Framework for Coronary Heart Disease and the NHS Plan set out national standards for the management of suspected heart attack, including challenging targets for reducing treatment delays for administration of thrombolytic therapy. This paper discusses the background, evidence base and challenges of implementing one component of the Government's drive to improve cardiac care: the NHS Plan commitment to a three year programme to equip and train ambulance paramedics to safely provide thrombolysis for appropriate patients. © 2002 Elsevier Science Ltd. All rights reserved.

关键词：救护车/组织和管理急救技师/教育英格兰卫生工作重点心肌梗死/药物疗法公费医疗/标准血栓溶解疗法时间因素全面质量管理人类

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Ambulance services: could the UK learn from the French?

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Accident and emergency nursing 1999年第2期7卷 79-82页

作者： Banks, T. University of Northumbria at Newcastle Newcastle upon Tyne United Kingdom

Ambulance services, as part of Accident and Emergency provision, are once again under scrutiny. This article reflects on a recent visit to a SAMU (Service d'Aide Medicale Urgente) unit in France, and considers those issues that could be explored in terms of effective UK provision. Recommendations will be proposed for future provision.

关键词：救护车/组织和管理急救医疗服务/组织和管理急救医学/教育预测法国国际教育交流模型组织管理方案评价人类

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急救车在急诊科的标准化管理方法探讨

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中国误诊学杂志 2011年第8期11卷 1868-1868页

作者：曾忆恋谢晓梅福建省厦门市第174医院急诊科 361000

目的保证急救车使用的有效性、安全性,提高抢救工作效率。方法急救车采用标准化管理,急救车内各类急救药品、物品统一标准和规格,放置标识明确。结果实施2 a多来,急救药车完好率为100%。结论急救车标准化管理方法明显提高了护理人员工... 详细信息

目的保证急救车使用的有效性、安全性,提高抢救工作效率。方法急救车采用标准化管理,急救车内各类急救药品、物品统一标准和规格,放置标识明确。结果实施2 a多来,急救药车完好率为100%。结论急救车标准化管理方法明显提高了护理人员工作效率及抢救成功率。

关键词：救护车/组织和管理急救医疗服务/组织和管理

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品质圈活动在抢救车管理中的应用

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临床护理杂志 2010年第5期9卷 66-66页

作者：徐春琴周世霞广西南宁市第一人民医院小儿外科南宁530022

品质圈简称QC小组,是本系统工作人员自愿组成,其目的是通过定期的选题会议和活动,解决和改善工作中的主要问题叫。在临床工作中,每个病区均设有抢救车,我科在提高抢救车质量管理活动中,进行品质圈活动,取得较好的效果,现介绍如下。[第一段]

关键词：品质圈救护车/组织和管理

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