Bianco A, Pileggi C, Angelillo I F
Medical School, University of Catanzaro Magna Graecia, Via Tommaso Campanella, 88100 Catanzaro, Italy.
Public Health. 2003 Jul;117(4):250-5. doi: 10.1016/S0033-3506(03)00069-6.
The purpose of this study was to determine the extent of non-urgent visits and the effect of different characteristics on such visits to one public hospital emergency department located in Catanzaro, Italy. Of 581 patients aged 15 years and older who were registered for care in the emergency department, 40 were excluded from the study as they were too ill or distressed. The survey questionnaire included questions about the patients' demographic and socio-economic characteristics, distance from home to hospital, usual health status and health status at the time of presentation to the emergency department. Of the 541 patients who agreed to participate, 19.6% of patients, according to the judgement of two observers, had non-urgent conditions. The results of the multiple logistic regression analysis showed that among all variables tested, age and sex were significant predisposing factors for utilization of the emergency department for non-urgent visits. Indeed, the odds of presenting for non-urgent care were significantly higher if patients were younger and female. Moreover, the odds of requiring non-urgent care were significantly higher in patients who present to the emergency department without medical referral and in patients who present with problems of longer duration. The most frequent reason given by patients for their visit to the emergency department was that they felt their problem was an emergency. Further investigations are necessary to evaluate the use of primary care since closer co-operation within the healthcare organization system may provide a more responsive service.
本研究的目的是确定非紧急就诊的程度，以及不同特征对意大利卡坦扎罗一家公立医院急诊科此类就诊的影响。在581名15岁及以上在急诊科登记接受治疗的患者中，有40名因病情过重或情况危急而被排除在研究之外。调查问卷包括有关患者的人口统计学和社会经济特征、从家到医院的距离、平时的健康状况以及就诊急诊科时的健康状况等问题。在同意参与的541名患者中，根据两名观察者的判断，19.6%的患者患有非紧急病症。多元逻辑回归分析结果显示，在所有测试变量中，年龄和性别是急诊科非紧急就诊利用情况的重要 predisposing 因素。事实上，如果患者年龄较小且为女性，非紧急护理就诊的几率显著更高。此外，在没有医疗转诊就前往急诊科的患者以及就诊问题持续时间较长的患者中，需要非紧急护理的几率显著更高。患者前往急诊科就诊最常见的原因是他们觉得自己的问题是紧急情况。由于医疗组织系统内更紧密的合作可能会提供更及时的服务，因此有必要进一步调查以评估初级保健的使用情况。
