目的 探讨虚拟云结算联合无陪护诊疗模式在急诊危重症患者管理中的应用效果。方法 浙江省某三级甲等综合医院急诊抢救室自2021年1月起实施跨学科多部门合作创立的诊疗模式，并进行持续优化。回顾性分析2020年1月—2023年12月36 551例患者的诊疗数据，按照诊疗模式的不同阶段分组比较：传统期（2020年，n=6 931）、新模式探索期（2021年，n=8 501）、新模式完善期（2022年，n=10 095）及新模式稳定期（2023年，n=11 024）。对各组间抢救室停留时间、血化验送检时间、用药等候时间、CT等候时间、缴费结算总次数及欠款总例次进行统计分析。结果 各时期之间抢救室停留时间、血化验送检时间、用药等候时间、CT等候时间及缴费结算总次数差异均具有统计学意义（P<0.001），各组间欠款总例次差异不具有统计学意义（P=0.998）。结论 该诊疗模式的创建对提高急诊抢救室患者精细化护理管理、改善就医体验具有重要意义。

Objective To explore the application effectiveness of a new diagnostic and treatment model combining virtual cloud billing with unaccompanied care in the management of critically ill emergency patients. Methods Starting from January 2021，a new treatment model involving interdisciplinary and multi-department cooperation was implemented and continuously optimized in the emergency rescue room of a tertiary class A hospital in Zhejiang Province. This retrospective study analyzed the treatment data of 36 551 patients from January 2020 to December 2023. The patients were grouped according to different stages of the treatment model，including traditional period（2020，n=6 931），new model exploration period（2021，n=8 501），new model improvement period （2022，n=10 095），new model stabilization period（2023，n=11 024）. Statistical analysis was conducted on the differences in emergency room stay time，blood test waiting time，medication waiting time，CT scan waiting time，total number of billing settlements and total instances of outstanding payments among the groups. Results There were statistically significant differences among the periods in terms of emergency room stay time，blood test waiting time，medication waiting time，CT scan waiting time，and total number of billing settlements（P<0.001）. There was no significant difference in the total instances of outstanding payments among the groups（P=0.998）. Conclusion The establishment of this new diagnostic and treatment model is of great significance in improving the refined management of patients in emergency rescue room and enhancing the medical experience.