Annals of Disaster Medicine |
ISSN:1684-193X |
Updated
Aug 18 , 2005 |
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Contents:
Volume 4, Number 1; July, 2005 |
Impact of Administrative Regulations Concerning Inter-hospital Transfer on Patient Disposition at Emergency Department |
Tzong-Luen Wang, MD, PhD; Hang Chang, MD, PhD |
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Abstract -- In 2005, Taipei Department of Health has implemented a new policy that demanded emergency
response hospitals reduce inter-hospital patient transfer. We therein designed the following
prospective study to explore the possible impacts of modifications in administrative policies on
inter-hospital transfer from emergency response hospitals. The data were collected r from Taipei EOC
and 7 related tertiary response hospitals from January 2004 to June 2005. Accordingly, the total
number of inter-hospital patient transfer via EOC was 1,284 and self-transfer 864 at stage I (from
January 2004 to December 2004). In other words, the number of EOC-mediated transfer was 107
per month and that of self-transfer 72 per month. In contrast, the number of EOC-mediated transfer
was 60 per month (P<0.05 vs. that at stage I) and self-transfer 41 per month (P<0.05 vs. that at stage I) at stage II (from January 2005 to June 2005). The interventions that the 7 hospitals used include active intervention of bed control by hospital administrators (7/7, 100% vs. 7/7, 100%, P=NS), interventions that increase bed turn-over rates after the administrative control has been undergoing (7/7, 100% vs. 4/7, 57%, P<0.01), establishment of the rules of extra bed arrangement and related patient disposition (7/7, 100% vs. 3/7, 43%, P<0.01), set-up of autonomic available bed reporting (7/7, 100% vs. 3/7, 43%, P<0.01), contracts concerning cooperation between the main hospitals and satellite hospitals (4/7, 57% vs. 0/7, 0%, P<0.01), monitoring of pre-hospital or inter-hospital transfer patient safety (7/7, 100% vs. . 4/7, 57%, P<0.01), standard operations procedure of mass casualties incident (7/7, 100% vs. . 4/7, 57%, P<0.01), and agreements concerning definitions of the criteria about the EOC-guided transfer (7/7, 100% vs. 4/7, 57%, P<0.01). In conclusion, the changes of administrative policies have been proven to influence the interventions that response hospitals utilized to control available beds.
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Key words--- Hospitalization; Inter-hospital Transfer; Pre-hospital Medicine; Emergency
Operations Center |
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