| Summary: | 碩士 === 義守大學 === 醫務管理學系 === 100 === Background: Out-of-hospital cardiac arrest (OHCA), although emergency medical has clear of steps implementation OHCA, but implementation on the quality of care remains need to be investigated. The quality of care is a multidimensional construct that cannot be measured directly. Thus, multiple indicators are used to construct a composite score to measure ‘quality’.
Objective: We investigate the association between the different composite scores developed from EMS-related process measures with post-discharge mortality.
Methods: Data were collected from Taipei City OHCA Registry from the period January 1, 2006 to December 31 2009. Taipei City OHCA Registry. The composite scores in our study were derived from the following two methods: the raw sum score and the all-or-none score methods. These composite scores were calculated based on two process measures (achieving prehospital ROSC and EMS response time < 5 minutes). Finally, the association between the composite scores and the post-discharge mortality was investigated.
Results: A total of 4,000 OHCA patients were analyzed, and were distributed across 44 EMS teams. The all-or-none score methods demonstrated a highest inverse relationship with post-discharge mortality and risk-adjusted post-discharge mortality respectively (-0.593, p < 0.01 and -0.482, p < 0.05) compared to the raw sum score and individual process measures.
Conclusion: When applying the composite scores, especially the all-or-none score to measure the quality of EMS care, we found they show the higher validity. Thus the composite score constructed by using a number of process measures may be used as an alternative approach to analyze and access the EMS quality.
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