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ObjectiveTo investigate the influencing factors associated with delayed time in pre-hospital emergency medical care in patients with hypertensive emergency in the main urban area of Chongqing. MethodsA total of 1 246 patients with hypertension in the main urban area of Chongqing from March 2018 to August 2021 were included in this study. The delayed time in the pre-hospital emergency medical care was determined. A multivariate linear regression model was used to analyze the influencing factors. ResultsThe delayed time in the pre-hospital emergency medical care for the patients with hypertensive emergency was concentrated in 0‒12 h， with the average of （5.89±1.96） h. The delayed time differed significantly by gender， age， history of atrial fibrillation， diabetes， educational level， time of onset， mode of transportation， awareness of hypertensive emergency， blood pressure at the onset， and presence of persons at the onset of emergency （P<0.05）. Multivariate linear regression analysis showed that educational level， time of onset， blood pressure at the onset， awareness of hypertensive emergency， presence of persons at the onset were linearly correlated with delayed time in the pre-hospital medical care for hypertensive emergencies （P<0.05）. ConclusionDelay in pre-hospital medical care is prevalent for patients with hypertensive emergency in the main urban area of Chongqing. The delayed time is associated with multiple factors， such as educational level， time of onset， blood pressure at onset， awareness of hypertensive emergency， and presence of persons at onset. It warrants further improvement in the interventions to reduce the delay in the pre-hospital medical care.
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Objective To investigate the current situation of pre-hospital trauma emergency medical care of Urumqi in 2011-2018 and predict the situation in the next five years,so as to provide a basis for rational allocation of pre-hospital emergency resources and improvement of health service system.Methods A total of 427 754 pre-hospital emergency patients were collected from January 1,2011 to December 31,2008 in Urumqi.Epidemiological methods were performed for statistical description and analysis.The single-factor gray model [GM (1,1)],multi-factor grey model and moving average model (MA1) was established for predicting the number of pre-hospital trauma patients each year.The single-factor gray model [GM (1,1)] and SARIMA model were used for the seasonal prediction.Results The male-female ratio of pre-hospital trauma patients was 1.98:1 and the incidence rate of male patients (534.91/100 000) was significantly higher than that of female patients (274.88/100 000) (x2=7 659.707,P＜0.01),and the incidence rate of male patients was 1.95 times higher than that of female patients.The trauma patients aged 35-59 years accounted for the largest proportion (42％),and the incidence of the disease was the highest among those aged ≥ 60 years old (644.23/100 000).The incidence ofpre-hospital trauma increased year by year (from 408.86/100 000 in 2011 to 550.02/100 000 in 2017),with a high incidence in summer (27 123,31.03％),especially in August (9 535,10.91％),most of which occurred in the new urban area (high-tech zone) (23 157,26.50％).The single-factor gray model [GM (1,1)],multi-factor gray model,and moving average model (MA1) predicted that the total number of pre-hospital trauma patients in 2023 was 13 118,11 715 and 13 305,respectively,and the MAE were 451.125 0,607.428 6,and 205.125 0,respectively.The single-factor gray model [GM (1,1)] and SARIMA model predicted the value in the summer of 2023 would be 3 638 and 4 999,respectively,and the MAE were 47.129 0 and 110.370 4,respectively.Conclusions The pre-hospital trauma in Urumqi is mainly male and young work-age adults,the incidence of the elderly is the highest,summer is the season of high incidence,and the new urban area (high-tech zone) is the primary district.The moving average model (MA1) model has a more accurate annual prediction,and the single-factor gray model [GM (1,1)] is the best model for seasonal prediction.The pre-hospital trauma emergency medical care demand will continue to increase in the next five years.The health administrative department should enlarge the allocation of pre-hospital emergency resources and improve the emergency service capabilities and efficiencies.
ABSTRACT
Objective@#To investigate the current situation of pre-hospital trauma emergency medical care of Urumqi in 2011-2018 and predict the situation in the next five years, so as to provide a basis for rational allocation of pre-hospital emergency resources and improvement of health service system.@*Methods@#A total of 427 754 pre-hospital emergency patients were collected from January 1, 2011 to December 31, 2008 in Urumqi. Epidemiological methods were performed for statistical description and analysis. The single-factor gray model [GM (1,1)], multi-factor grey model and moving average model (MA1) was established for predicting the number of pre-hospital trauma patients each year. The single-factor gray model [GM (1,1)] and SARIMA model were used for the seasonal prediction.@*Results@#The male-female ratio of pre-hospital trauma patients was 1.98:1 and the incidence rate of male patients (534.91/100 000) was significantly higher than that of female patients (274.88/100 000) (χ2=7 659.707, P<0.01), and the incidence rate of male patients was 1.95 times higher than that of female patients. The trauma patients aged 35-59 years accounted for the largest proportion (42%), and the incidence of the disease was the highest among those aged≥ 60 years old (644.23/100 000). The incidence of pre-hospital trauma increased year by year (from 408.86/100 000 in 2011 to 550.02/100 000 in 2017), with a high incidence in summer (27 123, 31.03%), especially in August (9 535, 10.91%), most of which occurred in the new urban area (high-tech zone) (23 157, 26.50%). The single-factor gray model [GM (1,1)] , multi-factor gray model, and moving average model (MA1) predicted that the total number of pre-hospital trauma patients in 2023 was 13 118, 11 715 and 13 305, respectively, and the MAE were 451.125 0, 607.428 6, and 205.125 0, respectively. The single-factor gray model [GM (1,1)] and SARIMA model predicted the value in the summer of 2023 would be 3 638 and 4 999, respectively, and the MAE were 47.129 0 and 110.370 4, respectively.@*Conclusions@#The pre-hospital trauma in Urumqi is mainly male and young work-age adults, the incidence of the elderly is the highest, summer is the season of high incidence, and the new urban area (high-tech zone) is the primary district. The moving average model (MA1) model has a more accurate annual prediction, and the single-factor gray model [GM (1,1)] is the best model for seasonal prediction. The pre-hospital trauma emergency medical care demand will continue to increase in the next five years. The health administrative department should enlarge the allocation of pre-hospital emergency resources and improve the emergency service capabilities and efficiencies.
ABSTRACT
Pre-bospital Emergency Medical Care (EMC) is special medical care based on emergency medical facilities, mainly providing emergency care for patients who need immediate and intensive care out of the hospital Over many years of practice, both patients and medical staff have realized that immediate access to emergency treatment is essential; quality of care is fundamental and effect is ultimate. Therefore, there is an urgent need to establish an overall, objective, and feasible evaluation system for the purpose of improving quality of care. In the present article, the author has designed a framework of quality evaluation system for pre-hospital EMC by means of formulating investigation plans and analyzing the indicators that reflect the quality of care being evaluated so as to promote the implementation of the evaluation system.