Explore the Associations Among Five-Levels in EmergencyTriage System,Waiting Time and Outcomes

• Main Authors: Yi-Wen Li, 黎伊文
• Other Authors: 孫秀卿
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/13256966716017909580

碩士 === 國立臺灣大學 === 護理學研究所 === 103 === Background: The aims of emergency triage were to care the appropriate patient at the right location within the appropriate time with the appropriate resources. The current emergency triage system in Taiwan is the five levels based on Taiwan Triage and Acuity Scale (TTAS). Patients in each level are assigned certain waiting time. Patients with the highest level (level 1) need to be processed immediately, patients with level 2 and level 3 may wait 10 minutes to 30 minutes, and for those who are level 4 and level 5 may wait 1 to 2 hours. People seeking medical treatment always regard themselves as the most critical, resulting in too many people visiting the emergency room. The overcrowded inpatients may cause prolonged waiting time which might cause an increasing mortality rate. Purposes: The aims of this secondary data analysis study at a medical center in northern Taiwan were to explore: (1) the correlation between the number of patients seeking emergency care every day, their assigned level categories, and their outcomes, and ; (2) understand whether assigning different levels, and different waiting periods to inpatients would influence their outcomes. The final outcomes are determined by the tracking of patients after emergency medical treatment which could be discharged, against medical advice, admission, transfer or death. Methods: This study was a secondary data analysis which regards the TTAS statistical data reporting a northern Taiwan medical center emergency room as its primary data resource. The collected time period was from 2012/08/01 to 2013/07/31. The data analysis was descriptive statistics and the inferential statistics with One-way ANOVA to explore the correlation between levels and waiting time. Decision tree was used to identify the correlation between assigned levels, waiting times and outcomes. Results: Five-levels in emergency triage system at the emergency clinic visits throughout the year up to 85,279 patients, with an average age of 53.43 years. The majority was triage level three with 58.5%, following by the triage level two (23%). Gender differences were found that more males were found in triage level one and two; whereas, more females were in levels three to five. In overall, those patients with longer emergency stay had the worse the outcomes, except triage level one and five. The longer emergency stay time of468 minutes (around eight hours) is the highest mortality rate with 6.3%; however, the times for triage and waiting to see a physician did not affect outcomes. The amount of patients per day only affected the outcomes of patients with triage level two; the number of people over than 347 /per day increased its hospitalization rates. It indicated that more numbers of patients in emergency room, and then the outcome of the patients with triage level two became worse. When the disease severity is worst with lower level of oxygenation and systolic blood pressure the higher level of triage system and the worst outcomes it became. Conclusion: With the results of this study that increasing the number of patients at emergency room will increase the mortality rate at triage level two. longer length of stay in emergency room will cause the worse outcomes with higher rate of hospitalization and mortality. . The length of stay of eight hours at emergency room is the highest mortality rate. Longer emergency stay had the worse the outcomes at other triage level , We hope that the results offer the important information for the public and we can persuade them to visit small and medium-level general hospital when the condition is not emergent. In order to improving the emergency medical care quality , the public should be well-educated how to access the emergent resources. . Key word: Emergency room，Five-level triage system，Waiting time，Outcome