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<<   作成日時 : 2010/07/26 20:26   >>

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 平均的な救急部門では1時間のテレビ番組"ER"が4本見られるほどの患者滞在時間になっているという。2010年の報告では、ER滞在時間は2008-2009年で4分増加し合計で4時間7分となった。2002年からみると31分の増加である。この結果は150万人の患者調査による。昨年の2008年救急部待機時間レポートで2分減少した報告に続くものである17州で平均待機時間は減少し、15州で5分以内の増加をみた。最も悪い州はユタ州で89分の増加で、2番目の州カンザスより2時間37分長い8時間17分だった。
 待ち時間が長くても患者満足度は100点満点で84点だった。6時間以上救急部にいた患者でも病院スタッフから遅れることの情報が良い場合は満足度は96.6だったという。1時間以内の人でも不十分なコミュニケーションの場合は満足度は41.0であった。
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ERでの待ち時間は平均約1時間/米国医療事情
http://kurie.at.webry.info/200808/article_17.html
救急での待ち時間延長が危険な状態に/米国医療事情 ER
http://kurie.at.webry.info/200801/article_30.html
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Fast Treatment Rare in Emergency Departments, Survey Says
While ERs in Some States Improve, Others Leave Patients Waiting Eight Hours or More
http://abcnews.go.com/Health/Wellness/er-wait-times-longer-survey/story?id=11240084
By TODD NEALE, MedPage Today Staff Writer
July 25, 2010

画像A patient waiting in a typical emergency department would have time to watch more than four one-hour long episodes of the iconic television show "ER," according to a survey by a national hospital consulting firm.
PHOTO A patient waiting in a typical emergency department would have time to watch more than four one-hour long episodes of the iconic television show "ER," according to a survey by a national hospital consulting firm.
(ADAM GAULT/Getty Images)

The average time a patient spent in the emergency department ticked up by four minutes from 2008 to 2009, which brought the total time to four hours and seven minutes, an increase of 31 minutes since 2002, according to the 2010 Emergency Department Pulse Report by Press Ganey, a hospital consulting firm.

The findings were based on survey results from 1.5 million patients.

The uptick follows a decrease of two minutes reported in last year's report on 2008 ED wait times.

Despite the increase, there were signs of improvement, with 17 states reducing their average wait time and 15 keeping increases to five minutes or less.

Patient satisfaction, which has improved over the past five years, remained high, but stagnated from about October 2008 through the end of 2009, according to Christina Dempsey, Press Ganey's vice president of clinical and operational consulting and a registered nurse.

"One year ago it appeared that this country's emergency care was robust despite the challenges of the current recession," she said on a conference call with reporters. "Perhaps the loss of jobs, loss of insurance, and [emergency department] overcrowding resulting from the recession has finally taken its toll."

Exacerbating the situation was a trend in recent decades of fewer hospitals with EDs trying to care for a greater number of patients.

Press Ganey surveyed 1,501,672 patients treated at 1,893 hospitals in 2009. Only patients who were discharged from the emergency department received a survey.

Although wait times increased, on average, by four minutes, certain states far exceeded that.

The worst performing state was Utah, which had an increase of 89 minutes in its average time spent in the ED. That brought the total time to eight hours and 17 minutes, two hours and 34 minutes longer than the state with the next longest wait time -- Kansas at five hours and 43 minutes.

The state that improved the most was Nevada, which cut its average wait time by 66 minutes. That brought the state's ranking to 37th from 43rd the year before.

Iowa had the shortest average wait time at two hours and 55 minutes, a decrease of seven minutes from 2008.

According to Dempsey, one way to reduce the time patients spend in the ED is to address bottlenecks in other areas of the hospital, particularly the operating rooms.

By smoothing the schedule of elective surgeries by scheduling procedures for non-peak times of day, fewer patients would have to wait in the ED for available beds.

But even with wait times ticking upward, patient satisfaction remained high, with an overall score of 84 on a scale of 100.

About two-thirds (65.7 percent) of patient comments were positive.

In general, satisfaction dipped with longer wait times, but other factors, like communication from hospital staff about delays, mitigated some of the effects.

For example, patients who spent six or more hours in the ED but reported very good communication about delays gave a satisfaction score of 96.6. Patients who were in and out of the ED in less than an hour but reported poor communication about delays gave a satisfaction score of just 41.0.

Improving comfort in the waiting room had a similar effect.

The top three priorities for improvement, according to the patients, were the same in 2009 as in 2008 -- keeping them informed about delays in care, controlling their pain, and improving the degree to which staff members care about patients personally.

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