Investigation and analysis of the trend of emergency patients in a 3rd grade class a hospital in 2016

Abstract

Objective To investigate the influence of meteorological factors on the number of patients and the time patients visiting the emergency department for medical care. Methods The data of meteorological variation and air pollution associated with the characteristics of distribution of time when the patients visited the emergency department in a tertiary grade A class hospital in Shanghai were collected in 2016. Quasi Poisson generalized additive model (GAM) applied for time series analysis was used to find the correlation between daily temperature and number of patients visiting emergency department, and with the distributed lag nonlinear model (DLNM) the relationship between the temperature and humidity was established and the confounding factors related with time visiting the emergency department was controlled in this model. Results In 2016, the average number of emergency visits in a tertiary grade A class hospital in Shanghai was 1027. The peak flow of patients occurred between 18:00 to-22:00 and trough emerged between 2:00 to-8:00. The number of visits in winter was greater than that in spring and autumn, and the number of patients on weekends and holidays was more than that on weekdays. The response of temperature exposure to the change of emergency volume in the hospital showed a J shape distribution. The low temperature and high temperature caused increase in visits, and the low temperature effect could last more than 2 weeks. The lowest number of visits occurred when the temperature (that is the lowest suitable temperature for medical treatment) was about 7 degrees Celsius, and the daily number of patients in emergency internal medicine was increased to 1.09 times (95%CI:1.03~1.16) compared with the optimum temperature. Compared with the optimum temperature, the daily visits increased to 1.27 times (95%CI:1.08~1.50) in the highest temperature. When the suitable temperature decreased by 1 degree, the visiting quantity increased by 2.43% (95%CI:0.83%~4.18%), and the number of visits increased by 0.96% (95%CI:0.31%~1.64%) every 1 degree rise. Conclusions There was a difference in the number of emergency visits between different times, and low temperature and high temperature had an obvious influence on the amount of emergency visits, and the effect of low temperature on the volume of visits was more lasting. Key words: Emergency; Number of visits; Average daily temperature; Distribution characteristics