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1.
Gesundheitswesen ; 82(5): 431-440, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-31394580

RESUMO

Medical care provided at the hospital emergency rooms in Germany has hardly been explored. On the occasion of restructuring the Municipal Hospital, the Munich City Council initiated the "Round Table Emergency Care" in order to determine reference figures for capacity planning. The present study was designed to analyze treatment data from 14 emergency departments which mainly carry the city's hospital emergency service. For inpatient cases, data were used in accordance with §21 Hospital Charges Act, for outpatient cases - as far as available - similar data were used, anonymized and combined with data from prehospital emergency medical services (EMS). In order to describe the domains treatment urgency, diagnostic/therapeutic effort and bed requirements, data were categorized in a 4-stage system. Over 12 months, 524,716 treatment cases were recorded: 34% were admitted to hospital, 80% came without EMS. One in 7 patients who independently went to an emergency room needed a bed in the intensive care or intermediate care unit (ICU/IMC). There were 64 cases per day and per 100,000 inhabitants requiring 7 ICU/IMC and 15 regular ward beds. Most cases (66%) were treated as outpatients and presented to the hospital's emergency department at times when facilities of the ambulatory care system would have been available. Urgency of these cases was usually low (50.9%), but effort was often high, due to diagnostics and surgical procedures. This study offers fundamental knowledge for planning emergency care. A large proportion of the presentations, especially those with injuries and those with diagnosis that require a more differentiated work-up, seem to be medically justified, which is why appropriate capacities have to be planned in. The study also shows that capacity planning on the basis of EMS cases alone is an inappropriate, one-sided approach.


Assuntos
Serviços Médicos de Emergência , Serviço Hospitalar de Emergência , Assistência Ambulatorial , Cuidados Críticos , Alemanha , Humanos
2.
Z Gesundh Wiss ; 23(4): 181-188, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26191488

RESUMO

AIM: In most regions of the world, the proportion of older people in the population has increased during the last decades. As this entails major consequences for the healthcare sector, this study isolates and quantifies the impact of an aging population on the demand for emergency medical services in different types of regions in Bavaria between 2012 and 2032. METHODS: Dispatch data of the emergency medical services were combined with population data and forecasts. Age-specific rates of emergency ambulance dispatches were calculated and used for a 20-year-projection for all 71 rural and 25 urban districts of Bavaria. Tests for differences between these two types of regions were applied. RESULTS: Per capita rates of emergency ambulance dispatches in urban regions tend to be higher and there is an urban-rural distinction in the rates of specific age groups. The projection predicted an overall increase in emergency ambulance dispatches by 21 % in Bavaria within 20 years, solely due to demographic effects. At the regional level, this demographic impact ranged from about -3 % to +41 %. There is a clear urban-rural distinction and the 28 regions with the strongest increase are all rural regions. CONCLUSION: The substantial demographic impact in combination with strong urban-rural variations should be accounted for in regional long-term planning as well as age-group specific innovation in the emergency medical services. As demography is not the only significant demand factor, the identification and quantification of other factors remains a challenge for further research.

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