2014至2018年深圳市南山区10 590例院前急救救护车空诊案例分析及对策研究

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目的:调查分析深圳市南山区院前急救救护车的空诊案例,为减少院前急救救护车空诊率和分级调度制度建设提供依据。方法:统计2014至2018年经华中科技大学协和深圳医院(即南山区唯一一家三甲医院)救护车出诊后因呼叫者原因接不到患者的登记资料,分析空诊原因、空诊发生的时间段(每3 h为1个时间段)和呼叫120原因。结果:① 2014至2018年深圳市南山区院前急救救护车空诊率呈逐年波动下降趋势,分别为31.22%(2 515/8 055)、26.94%(2 147/7 970)、29.80%(2 398/8 046)、25.69%(1 844/7 177)和21.89%(1 686/7 703),5年总空诊率为27.19%(10 590/38 951)。②空诊原因分布:10 590次空诊事件中前3位分别为来电取消、车到人走和患者自送,分别占36.87%、25.08%和17.03%,各年空诊原因构成比差异有统计学意义(χn 2=217.626,n P<0.001)。③空诊时间段分布:发生空诊事件的前3个时间段分别为21:00~23:59、18:00~20:59和09:00~11:59,分别占16.86%、14.95%和13.54%,各年空诊时间段分布差异无统计学意义(χn 2=32.571,n P=0.252)。④呼叫120原因分布:10 590次空诊事件中,前5位呼叫120原因分别为晕倒/晕厥、外伤、酒精中毒、交通事故伤、斗殴,分别占20.13%、15.67%、9.97%、8.64%和6.45%,呼叫120原因分布在各年间的分布差异有统计学意义(χn 2=194.213,n P<0.001)。n 结论:深圳市南山区院前急救救护车空诊率较高,患方取消救护车服务是造成空诊的主要原因;提高调度员的专业水平和分诊能力,完善院前急救制度建设和加大社会宣传有利于降低空诊率。“,”Objective:To provide a scientific basis for reducing the rate of invalid ambulance attendance and the establishment of grades dispatch system through a retrospective analysis of the invalid ambulance attendance in prehospital emergency care.Methods:The data of the invalid ambulance attendance was collected in Huazhong University of Science and Technology Union Shenzhen Hospital (the only tertiary hospital of in Nanshan District) from 2014 to 2018, and the reasons of the invalid ambulance attendance, the time period during the invalid ambulance attendance occurred (every 3 hours was divided into one time period), and the reasons of ambulance calling were statistically analyzed.Results:① The invalid ambulance attendance rates showed a fluctuating decrease trend year by year from 2014 to 2018, the rates were 31.22% (2 515/8 055), 26.94% (2 147/7 970), 29.80% (2 398/8 046), 25.69% (1 844/7 177) and 21.89% (1 686/7 703), respectively. The total invalid ambulance attendance rate was 27.19% (10 590/38 951) in the five years. ② The top three reasons for the invalid ambulance attendance were cancelled calls, departure before the ambulance arrived, and going to hospital by themselves, accounting for 36.87%, 25.08%, and 17.03%, respectively. The constituent ratios of the causes of invalid ambulance attendance in each year were different with statistical significance (χn 2 = 217.626, n P < 0.001). ③ The top three time period of invalid ambulance attendance occurred at 21:00-23:59, 18:00-20:59 and 09:00-11:59, accounting for 16.86%, 14.95% and 13.54%, respectively. There was no statistical significance in the distribution of time period in each year (χ n 2 = 32.571, n P = 0.252). ④ The top five reasons for ambulance calling of invalid ambulance attendance were fainting/syncope, trauma, alcoholism, traffic accident injuries, and brawls, accounting for 20.13%, 15.67%, 9.97%, 8.64%, and 6.45%, respectively, and there was statistically significant difference in the distribution of the reason for ambulance calls in each year (χn 2 = 194.213, n P < 0.001).n Conclusion:The invalid ambulance attendance rate is high in Nanshan District of Shenzhen. Improving the professional level and triage ability of the dispatchers, improving the system construction of prehospital emergency care system and increasing social education are conducive to reduce invalid ambulance attendance rate.
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