量化救护车滞留的影响：维多利亚州紧急医疗服务案例的多年分析
Quantifying the Impact of Ambulance Ramping: A Multi-Year Analysis of Victorian Emergency Medical Services Cases
- The Centre of Excellence in Paramedicine (CoEP), Victoria University（卓越急救医学中心（CoEP），维多利亚大学）
- Center for Research and Evaluation Ambulance Victoria（维多利亚救护车研究与评估中心）
机构由 AI 辅助整理，请以论文原文为准。
AI总结：
本研究通过分析维多利亚州285万次救护车出勤数据，量化了救护车滞留的规模与动态，发现累计损失149万小时，且滞留与医院到达并发性相关，为医院状态感知的救护车路由提供了经验依据。
AI中文摘要：
救护车滞留，即医院到达与患者交接之间的延迟，是紧急医疗服务（EMS）中的一个关键运营瓶颈，然而其系统性规模和动态在规模上仍未得到充分表征。本文量化了整个州级EMS系统中滞留的规模、轨迹和运营相关性，使用探索性数据分析（EDA）分析了2020年1月至2024年3月期间澳大利亚维多利亚州的2,850,575次救护车出勤。经过系统预处理后，对59家设有急诊科（ED）的医院和79个地方政府区域（LGA）的2,026,569次急诊科转运队列进行了区间分解、帕累托集中度、小时交叉相关性、医院到达并发性和按优先级分层的运营比较。累计救护车小时损失（AHL）总计1,491,127小时，相当于研究窗口期间每天约96个十小时救护车班次损失。59家医院中有10家占50.9%病例的57.8%损失小时。年度损失上升57%，在2022年达到峰值，而转运需求下降3.7%，表明每例交接恶化而非需求增长。交接持续时间随患者病情严重程度变化不大，但随前一小时到达同一医院的救护车数量单调增加，这种效应在一天中的每个小时都存在。每小时需求与两到四小时后的滞留中度相关（r = 0.365）。这些发现为医院状态感知的救护车路由建立了经验前提。
英文摘要：
Ambulance ramping, the delay between hospital arrival and patient handover, is a critical operational bottleneck in Emergency Medical Services (EMS), yet its systemic magnitude and dynamics remain inadequately characterised at scale. This paper quantifies the scale, trajectory, and operational correlates of ramping across an entire statewide EMS system, analysing 2,850,575 ambulance attendances in Victoria, Australia from January 2020 to March 2024 using an Exploratory Data Analysis (EDA). After systematic preprocessing, an analytical cohort of 2,026,569 Emergency Department (ED) transports across 59 hospitals with ED and 79 Local Government Areas (LGA) was examined through interval decomposition, Pareto concentration, hourly cross-correlation, hospital arrival concurrency and priority-stratified operational comparisons. Cumulative Ambulance Hours Lost (AHL) totalled 1,491,127 hours, equivalent to approximately 96 ten-hour ambulance shift lost every day of the study window. Ten of 59 hospitals account for 57.8% of lost hours from 50.9% of cases. Annual losses rose 57% to a 2022 peak while transported demand fell 3.7%, indicating deterioration in per-case handover rather than growth in demand. Handover duration varies little with patient acuity, but rises monotonically with the number of ambulances arriving at the same hospital in the preceding hour, an effect persisting within every hour of the day. Hourly demand is moderately associated with ramping two to four hours later (r = 0.365). These findings establish the empirical preconditions for hospital-state aware ambulance routing.
