| Summary: | 碩士 === 國立成功大學 === 高階管理碩士在職專班(EMBA) === 103 === Emergency Department (ED) crowding has been an important issue in the health insurance and medical quality for decade. Prolonged waiting time for admission to inpatient wards, also known as ED boarding, has been identified as a key contributor to ED crowding worldwide. As a result of the evolution of National Health Insurance, the rapid expanding health care market along with the increasing instant demand from patients have been acknowledge to poor service quality and inevitable medical errors, in which leads to negative outcomes such as an increase in patient complaints and lower rankings of patient satisfaction.
This paper aims to provide a high-fidelity model to capture the dynamics of inpatient flow of ED with a particular focus on the following factors- patients’ demographics, residential area, triage, and patient flow trends. The big data was downloaded in which contains more than 270,000 records in the last four years. This study analyzed not only the waiting time in ED, the last admit/discharge time but also the causes of boarding time over both six and 24 hours. The expected department of medical care was also surveyed. In addition, this study examined the effect of the Taiwan triage and acuity scale (TTAS) on ED crowding to further understand the impact to ED boarding status. We used OLAP tool to analyze the included big data. Based on the analyses of various dimensions in the relevant issues in ED boarding/crowding, this study could provide insights to the management of instant patient flow control. As a consequence, the causes of ED boarding could be identified and the alert system can help hospital to be more efficiently and effectively allocating the medical resources to provide better health care to patients.
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