Abstract
The purpose of this study was to quantitatively show the causal relationship between “the responsiveness of the emergency medical service system” and “the amount of medical services provided” that represents the whole scale of the hospital system in stroke patients admitted to the emergency department. The subjects in this study were 48 moderate stroke patients of the 144 patients who visited the emergency outpatient clinic of A hospital in Tokyo in 2008, and who were diagnosed as having had a stroke and admitted to the emergency ward.
The relationships between observed variables such as “time to CT,” “the score of involved physicians” and “the number of emergency outpatients” were represented by undirected independence graphs in graphical modeling and, based on the results, the causal relationship was investigated using structural equation modeling (SEM) with “the responsiveness of the emergency medical service system,” “the amount of medical services provided” and “the degree to which emergency outpatients are received” as structural concepts. The results suggested that “the amount of medical services provided” and “the degree to which emergency outpatients are received” have the same level of influence on “the responsiveness of the emergency medical service system.” In addition, a correlation was shown between “the amount of medical services provided” and “the degree to which emergency outpatients are received.” From this, it was considered necessary in hospital management to grasp in a timely and objective manner both conditions, i.e., the amount of medical services provided and the degree to which emergency outpatients are received, and to establish a function with the power to make adjustments between outpatient department, ward section, clinical laboratory and so on, to enhance the responsiveness of the emergency medical service system.
