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응급실 체류시간 제한이 과밀화 및 진료의 질에 미치는 영향: 체계적 문헌고찰과 메타분석

Other Titles
 The effect of time target on overcrowding and clinical quality in the ED: a systematic review and meta-analysis 
Authors
 윤병석  ;  좌민홍  ;  공태영  ;  주영선  ;  고동률  ;  황윤정  ;  박인철  ;  정성필  ;  이혜선 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.29(2) : 170-178, 2018 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2018
Keywords
Healthcare quality indicators ; Crowding ; Emergency department
Abstract
Objective: Many studies have reported the effectiveness of the ‘time target’ on reducing emergency department (ED) overcrowding and improving clinical quality. This study examined the effects of introducing the time target on ED overcrowding and clinical quality using meta-analysis. Methods: The electronic databases including PubMed (Medline), Cochrane Library, and Embase until June 2017 were searched. The search keywords were ‘time target,’ ‘national emergency access target,’ ‘four-hour rule,’ and ‘shorter stays in ED’. Two investigators selected and reviewed articles according to the predefined inclusion and exclusion criteria. The quality of the articles was evaluated using the RoBANS checklist. The data were abstracted by predetermined criteria and meta-analysis was performed using RevMan software. Results: Of 721 articles, 16 studies were included in the final analysis. A meta-analysis of four studies on the ED length of stay (LOS) showed that the mean EDLOS was reduced by 0.64 hours (95% confidence interval [CI], 0.34-0.94) since the introduction of the time target. Other studies also showed that the EDLOS was reduced. There was no definite trend in the hospital admission rate. Meta-analysis of nine studies on the clinical quality revealed a total odds ratio of 1.02 (95% CI, 0.74-1.32). Time taken until the visitation of a doctor and the initiation of treatment were both reduced. The rate of “left without being seen” was decreased. Conclusion: EDLOS was reduced and no significant association was observed between mortality and the application of a time target since the introduction of time target. ‘Rate of revisiting,’ ‘time to clinician,’ ‘time to treatment,’ and ‘rate of left without being seen’ was reduced.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Ko, Dong Ryul(고동률) ORCID logo https://orcid.org/0000-0002-3098-2784
Kong, Tae Young(공태영) ORCID logo https://orcid.org/0000-0002-4182-7245
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
Yoon, Byoung Seok(윤병석)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Choa, Min Hong(좌민홍) ORCID logo https://orcid.org/0000-0003-0338-994X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167199
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