Characteristics of Emergency Departments in the Paris Metropolitan Area: the NEDI-Paris Survey

摘要

Aims: The National Emergency Department Inventory (NEDI) project is comprised of several local and national surveys of emergency departments (EDs) in a specific region. These databases reflect the diversity of EDs worldwide. The purpose of our study was to describe the characteristics of EDs in Paris (France) metropolitan area, with particular attention to available resources and capacity of these EDs depending on their public or private status. Procedure: All EDs opened 24/7 were included. The previously-used NEDI survey included 29 items regarding services characteristics during the year 2015. A response rate of at least 80 was required for study success. Results: Out of the 117 eligible EDs, 97 participated (83 response rate). All of these EDs were located in hospitals. The vast majority of EDs (86) had a contiguous layout of care. The median annual ED visit rate was 34,000 (interquartile range, 23,000-56,000). Sixty-six centers were public (68) including 22 academic centers, and 31 (32) were private (non-academic). EDs caring for adults only, children only, and both represented 54, 26, and 20 of our sample, respectively. They reported a median waiting time of less than one hour in 25 of cases: 42 for private EDs vs 17 for public EDs (P = 0.01). There was 54 of centers that reported a mean admission rate of below 20, similar between private and public sectors (60 vs 50, respectively; P = 0.40). Surveyed centers reportedly suffered from running overcapacity in 22 of cases that was more frequent in public EDs (27 vs 10 in private EDs). Public hospitals presented with available 24/7 management of diverse patho-logies as well as specialist referral more often than in private centers, and particularly in academic centers. Conclusion: The NEDI-Paris survey showed significant variability in the characteristics and resources of Paris area EDs. A major driver of these differences appeared to be whether the ED was in public or private sector. Our survey establishes a benchmark to reflect on improvements in Paris area emergency care.