TY -非盟的陈Rai-Fu AU - Cheng Kuei-Chen AU -林,共盟- Chang I-Chiu盟——蔡Cheng-Han PY - 2021 DA - 2021/7/28 TI -预测计划外急诊科返回访问中老年人:以人群为基础的回顾性研究乔-地中海JMIR通知SP - e22491六世- 9 - 7 KW -分类模型KW -决策树KW -急诊科千瓦年长的成人患者KW -计划外访问返回AB -背景:急诊不定期复诊(EDRVs)是监测急诊医疗质量的关键指标。高回复率说明急诊科提供的医疗服务未能达到准确诊断和有效治疗的预期效果。老年人比青年人更容易发生疾病和合并症，他们表现出独特而复杂的临床特征，增加了临床诊断和治疗的难度。老年人也比其他年龄组的人使用更多的紧急医疗资源。许多研究综述了普通急诊科患者edrv的原因;然而，很少有人关注老年人，尽管这是edrv发病率最高的年龄组。目的:本研究的目的是建立一个预测65岁及以上患者72小时内非计划性edrv的模型。此外，我们的目的是探讨影响因素对他们的计划外edrv的影响。方法:我们使用台湾国民健康保险研究数据库的分层随机数据，并应用数据挖掘技术构建包含患者、疾病、医院和医生特征的预测模型。 Records of ED visits by patients aged 65 years and older from 1996 to 2010 in the National Health Insurance Research Database were selected, and the final sample size was 49,252 records. Results: The decision tree of the prediction model achieved an acceptable overall accuracy of 76.80%. Economic status, chronic illness, and length of stay in the ED were the top three variables influencing unscheduled EDRVs. Those who stayed in the ED overnight or longer on their first visit were less likely to return. This study confirms the results of prior studies, which found that economically underprivileged older adults with chronic illness and comorbidities were more likely to return to the ED. Conclusions: Medical institutions can use our prediction model as a reference to improve medical management and clinical services by understanding the reasons for 72-hour unscheduled EDRVs in older adult patients. A possible solution is to create mechanisms that incorporate our prediction model and develop a support system with customized medical education for older patients and their family members before discharge. Meanwhile, a reasonably longer length of stay in the ED may help evaluate treatments and guide prognosis for older adult patients, and it may further reduce the rate of their unscheduled EDRVs. SN - 2291-9694 UR - https://medinform.www.mybigtv.com/2021/7/e22491 UR - https://doi.org/10.2196/22491 UR - http://www.ncbi.nlm.nih.gov/pubmed/34319244 DO - 10.2196/22491 ID - info:doi/10.2196/22491 ER -