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菲律宾农村初级保健系统中会诊的周转时间:一项描述性回顾性队列研究。

Turnaround Time of Consults in a Primary Care System in Rural Philippines: A Descriptive Retrospective Cohort Study.

作者信息

Barbadillo April Faye P, Dans Leonila F, Tan-Lim Carol Stephanie C, Galingana Cara Lois T, Sanchez Josephine T, Aquino Maria Rhodora N, Amit Arianna Maever L, De Mesa Regine Ynez H, Rey Mia P, Panganiban Janelle Micaela S, Poblete Karl Engelene E, Sundiang Nanette B, Dans Antonio L

机构信息

Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila.

Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila.

出版信息

Acta Med Philipp. 2024 Oct 15;58(18):20-26. doi: 10.47895/amp.vi0.8320. eCollection 2024.

Abstract

BACKGROUND

Turnaround time is an integral component of primary healthcare and is a key performance indicator of healthcare delivery. It is defined as the time patients spend during a healthcare facility visit. In this study, turnaround time is defined as the time elapsed from registration to the end of consultation.

OBJECTIVES

This study aimed to determine the turnaround time of consults in the primary care system in a rural site in the Philippines, and compare turnaround time during the pre-pandemic and COVID-19 pandemic periods.

METHODS

This is a retrospective cohort study of patients seen at the primary care facility under the Philippine Primary Care Studies (PPCS) rural site from April 2019 to March 2021. Patients included in this study were chosen through random sampling. Electronic medical records (EMR) of these patients were reviewed. Turnaround time was computed electronically from time of registration to end of consultation. Descriptive statistics was used to summarize data and report turnaround time. The turnaround time before and during the pandemic was compared using an independent sample t-test (if normally distributed) or Mann Whitney U test (if not normally distributed). A p-value of <0.05 was considered statistically significant.

RESULTS

A random sample of 342 patients out of the total 45,501 patient consults seen at the rural primary healthcare facility from April 2019 to March 2021 were included in this study. The median turnaround time was 29.0 minutes (interquartile range [IQR] 68.3), with range of 0.9 to 437.2 minutes. During the pre-pandemic period, the median turnaround time of consults is 29.3 minutes (IQR 70.4) which is 1.8 minutes longer than the pandemic period which showed median turnaround time of 27.5 minutes (IQR 72.7). The difference between the two time periods was not statistically significant (P = 0.39).

CONCLUSION

The study showed that the median turnaround time of medical consults was 29.0 minutes, which was shorter by 80 minutes compared to other published Philippine studies. The turnaround time did not differ significantly in the pandemic and pre-pandemic period, despite new policies and systems that were implemented during the pandemic.

摘要

背景

周转时间是初级医疗保健的一个重要组成部分,也是医疗服务提供的关键绩效指标。它被定义为患者在医疗机构就诊期间所花费的时间。在本研究中,周转时间被定义为从挂号到会诊结束所经过的时间。

目的

本研究旨在确定菲律宾一个农村地区初级保健系统中会诊的周转时间,并比较疫情前和新冠疫情期间的周转时间。

方法

这是一项对2019年4月至2021年3月在菲律宾初级保健研究(PPCS)农村站点的初级保健机构就诊的患者进行的回顾性队列研究。本研究中的患者通过随机抽样选取。对这些患者的电子病历(EMR)进行了审查。周转时间从挂号时间到会诊结束通过电子方式计算。使用描述性统计来汇总数据并报告周转时间。使用独立样本t检验(如果呈正态分布)或曼-惠特尼U检验(如果不呈正态分布)比较疫情前和疫情期间的周转时间。p值<0.05被认为具有统计学意义。

结果

在2019年4月至2021年3月期间,该农村初级保健机构总共45501次患者会诊中,随机抽取了342名患者纳入本研究。周转时间的中位数为29.0分钟(四分位间距[IQR]为68.3),范围为0.9至437.2分钟。在疫情前时期,会诊的周转时间中位数为29.3分钟(IQR为70.4),比疫情期间长1.8分钟,疫情期间周转时间中位数为27.5分钟(IQR为72.7)。两个时间段之间的差异无统计学意义(P = 0.39)。

结论

该研究表明,会诊的周转时间中位数为29.0分钟,与菲律宾其他已发表的研究相比缩短了80分钟。尽管在疫情期间实施了新的政策和系统,但周转时间在疫情期间和疫情前时期没有显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c31a/11522336/bc713b042a42/AMP-58-18-8320-g001.jpg

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