Laursen M B, Jensen H P
Aalborg Sygehus, ortopaedkirurgisk afdeling.
Ugeskr Laeger. 1999 Aug 16;161(33):4624-7.
Misuse of accident and emergency (A&E) departments is a problem throughout the world. Staffing A&E departments with general practitioners has been reported as successful in a few prospective studies. A medical audit of all A&E charts during one week was carried out. The audit-panel included two orthopaedic surgeons and two general practitioners. The charts were divided in two groups: 1) true A&E cases, 2) inappropriate A&E users, who should have visited the general practitioners' acute consultation instead. There was substantial agreement between audit-panel groups that 57% of attenders could visit the general practitioner instead. Ten percent of attenders received no treatment in the A&E department, but were transferred to other departments within the hospital. It is concluded that two-thirds of the A&E department attenders could have visited the general practitioners instead, for treatment or for referral to the relevant hospital department.
急诊(A&E)部门的滥用现象是一个全球性问题。在一些前瞻性研究中,有报告称配备全科医生的急诊部门取得了成功。对一周内所有急诊病历进行了医学审计。审计小组包括两名骨科外科医生和两名全科医生。病历被分为两组:1)真正的急诊病例,2)不适当使用急诊的患者,这些患者本应去看全科医生的急性咨询门诊。审计小组之间存在很大程度的共识,即57%的就诊者可以去看全科医生。10%的就诊者在急诊部门未接受治疗,而是被转到医院的其他科室。结论是,三分之二的急诊部门就诊者本可以去看全科医生,以接受治疗或被转诊到相关医院科室。