Cunningham P J, Clancy C M, Cohen J W, Wilets M
Center for Studying Health System Change, Agency for Health Care Policy and Research, USA.
Med Care Res Rev. 1995 Nov;52(4):453-74. doi: 10.1177/107755879505200402.
The use of the hospital emergency department (ED) for nonurgent health problems has been a subject of considerable controversy, in part because there is no widely accepted definition of "nonurgent." Elimination or substantial reduction in nonurgent ED use is frequently offered as a strategy for reducing health expenditures. Previous studies, often limited to individual hospitals or communities, have limited generalizability and do not permit examination of multiple factors likely to influence nonurgent ED utilization or examination of ED use for nonurgent problems in the context of overall outpatient utilization. This analysis of the 1987 National Medical Expenditure Survey (NMES) provides a nationally representative examination of nonurgent ED utilization that describes the frequency of ED use for nonurgent problems, characteristics of individuals that are associated with an increased likelihood of nonurgent ED use, the use of other outpatient physician services, and expenditures associated with nonurgent ED visits.
利用医院急诊科处理非紧急健康问题一直是一个备受争议的话题，部分原因是对于“非紧急”没有被广泛接受的定义。消除或大幅减少非紧急情况下对急诊科的使用常常被当作降低医疗支出的一项策略。以往的研究通常局限于个别医院或社区，普遍适用性有限，并且无法在整体门诊利用的背景下考察可能影响非紧急急诊科利用的多个因素，也无法考察针对非紧急问题的急诊科使用情况。对1987年国家医疗支出调查（NMES）的这项分析提供了一项具有全国代表性的对非紧急急诊科利用情况的考察，它描述了因非紧急问题而使用急诊科的频率、与非紧急情况下增加使用急诊科可能性相关的个体特征、其他门诊医生服务的使用情况以及与非紧急急诊科就诊相关的支出。
