| Abstract | Cilj: Cilj ovog rada je istraživanje zahtjeva i potreba za hitnim bolničkim prijemom u Općoj bolnici Ogulin od 2013.- 2015. godine , uz prikaz organizacije rada objedinjenog hitnog bolničkog prijema. Materijali i metode: Istraživanje je provedeno retrogradno, uvidom u podatke iz bolničkog informacijskog sustava, o broju i razlozima dolazaka bolesnika pregledanih na Odjelu za hitnu medicinu Opće bolnice Ogulin, kroz period od početka prosinca 2013. - 31.12.2015. Prikazani su podaci učinkovitosti rada Odjela za hitnu medicinu, maksimalno vrijeme čekanja bolesnika na pregled liječnika obzirom na trijažnu kategoriju te udio preživjelih i duljina boravka bolesnika u Odjelu hitne medicine za dijagnoze prestanka rada srca, politraume, prometnih nezgoda, politrauma u prometnim nezgodama i kardijalnih simptoma. Rezultati: Od početka rada pa do kraja 2015. godine odjel hitne medicine obradio je 23789 bolesnika. Najčešća dijagnoza je povišena tjelesna temperatura zbog koje je 1457 bolesnika zatražilo liječničku pomoć, što je udio od 6.12% ukupnih dolazaka, dok je bolesnika sa dijagnozama prestanka rada srca, politraume, prometnih nezgoda, politrauma u prometnim nezgodama i kardijalnih simptoma bilo svega 3.32%. Ukupno je bilo 23 789 bolesnika sa 356 različitih dijagnoza, te je to razlog za mali udio pojedinih, pa i vodećih dijagnoza. Od ukupnog broja bolesnika njih je 7 196 bilo prve, druge i treće trijažne kategorije, odnosno kojima je pomoć bila neophodna, a 16 593 bolesnika bilo četvrte i pete trijažne kategorije, koji nisu bili hitni. Podaci o učinkovitosti rada Odjela za hitnu medicinu ogulinske bolnice govore u prilog povećanja učinkovitosti za trijažne kategorije 1 i 2. Za trijažnu kategoriju 1 je učinkovitost sa 40% 2014. godine porasla na 100% 2015. godine, a za trijažnu kategoriju 2 sa 84.58% 2014. godine na 95.2% 2015. godine. U 2015. godini smanjena je duljina boravka bolesnika u Odjelu hitne medicine. Ipak u prikazanim podacima se ne vidi napredak u smislu smanjenja smrtnosti u odnosu 2014. i 2015. godine. Zaključak: U Odjelu hitne medicine Opće bolnice Ogulin postoji veliki nesrazmjer između zahtjeva za hitnom službom i stvarnih potreba bolesnika za hitnom medicinskom pomoći. Od ukupnog broja bolesnika njih 30,25% je stvarno trebalo hitnu pomoć, a 69,75% je bilo bolesnika koji nisu bili hitni. Međutim, reorganizacija hitnog prijema je utjecala na duljinu čekanja pacijenata što je vidljivo iz usporedbi učinaka u 2015. godini u odnosu na 2014. godinu, u 1. trijažnoj kategoriji više nema liste čekanja, a u 2. se smanjila za nešto više od 10%. Nova organizacija hitne službe doprinijela je smanjenju vremena koje bolesnici provode u Odjelu hitne medicine, ali do sada se ne pokazuje napredak u smanjenju smrtnosti. |
| Abstract (english) | Objective: The objective of this study is to investigate the application and the need for emergency hospital admission to the General Hospital Ogulin of 2013.- 2015, with a review of the organization of work integrated emergency hospital admission. Materials and Methods: The study was conducted retroactively, by examining the data from the hospital information system, the number and reasons for arrivals patients examined at the Department of Emergency Medicine, General Hospital Ogulin, the period from the beginning of December 2013 - 31.12.2015. The data presented are the effectiveness of the Department of Emergency Medicine, the maximum waiting time for patients on medical examination considering the triage category and the proportion of survivors and length of stay of patients in the department of emergency medicine for the diagnosis of heart failure, multiple trauma, accidents, polytrauma in traffic accidents and cardiac symptoms . Results: : From the beginning to the end of 2015, the department of emergency medicine processed 23789 patients. The most common diagnosis was fever because of the 1457 patients sought medical attention, as a share of 6.12% of the total arrivals, while the patients with the diagnosis of heart failure, multiple trauma, accidents, polytrauma in traffic accidents and cardiac symptoms was only 3.32%. There were 23789 patients with 356 different diadnoses, and this is the reason for a small proportion of individual, as well as the leading diagnosis. Of the total number of patients them is 7196 was the first, second and third triage category, and that help was necessary, and 16593 patients were fourth and fifth triage categories, which were not urgent. Data on the effectiveness of the Department of Emergency Medicine Ogulin hospital in favor of increasing the efficiency of triage category 1 and 2. Data on the effectiveness of the Department of Emergency Medicine Ogulin hospital in favor of increasing the efficiency of triage category 1 and 2. The triage category 1 is the efficiency from 40% in 2014 increased to 100% in 2015, and for triage category 2 with 84.58% in 2014 to 95.2% in 2015. In 2015, we reduced the length of stay of patients in the department of emergency medicine. In the data presented do not see progress in terms of reducing mortality in relation to 2014 and 2015. Conclusion: The Department of Emergency Medicine, General Hospital Ogulin there is a huge disparity between the demand for emergency services and the real needs of patients for medical emergencies. Of the total number of patients they 30.25% is really needed an ambulance, and 69.75% were patients who were not urgent. However, the reorganization of emergency has affected the length of the waiting patients as demonstrated by the comparison of effects in 2015 compared to 2014, in the first triage category no longer waiting lists, and the second was reduced by just over 10%. The new organization of the emergency services has contributed to reducing the time patients spend in the department of emergency medicine, but so far does not show progres in reducing mortality. |
