Lattere M, Rosati U, Chiossi M, Facco F, Magnani M, Calvi A, Renna S, Bonassi S
Servizio di P.S., Accettazione e Osservazione, Istituto Scientifico G. Gaslini, Genova.
Minerva Pediatr. 1992 Sep;44(9):407-12.
A perspective study was carried out at the Emergency Department of the Gaslini Institute on a sample of the children admitted from May to September 1990. The study aimed to describe types and modalities of admission. "G. Gaslini" Institute is a multidisciplinary children's hospital: 45% of patients admitted in the hospital come from the southern regions of Italy, while the admission at the Emergency Department were local in 82%. Among all children considered, 2080 (71.9% were admitted on request of their parents, who did not ask previously any physician; of those cases, 356 (17%) were hospitalized, 474 (25%) were either examined by specialist or treated and then discharged. In the remaining cases, no intervention was necessary. As a consequence, 58% of children were admitted without any clinically plausible reason. Parents' anxiety clearly played an important role in most cases. 840 children were addressed to the Emergency Department by a physician, 652 (22.3%) by the doctor in charge, 213 (32.7%) of which were sent back home by the doctor on duty, who did not think it necessary any treatment. Of the 120 (4.1%) children sent by different Emergency Departments, 95 (79.1%) were hospitalized. The reason why physicians addressed quite a large number of children to the Emergency Department, when they didn't need any intervention remain nucleo. Their diagnosis, in fact, agreed with those of the doctor on duty in 83% of cases. In conclusion, it is difficult to imagine a diagnostic or therapeutic problem which needs specific structures. Cooperative programs with physicians working in our region will be carried out in order to control, where possible, admission to Emergency Departments.
在加斯利尼研究所急诊科对1990年5月至9月收治的儿童样本进行了一项前瞻性研究。该研究旨在描述入院类型和方式。“G. 加斯利尼”研究所是一家多学科儿童医院：入院患者中有45%来自意大利南部地区，而急诊科的入院患者82%来自当地。在所有被考虑的儿童中，2080名（71.9%）是应家长要求入院的，家长此前未咨询过任何医生；在这些病例中，356名（17%）住院治疗，474名（25%）接受了专科医生检查或治疗后出院。其余病例无需干预。因此，58%的儿童入院时没有任何临床上合理的理由。在大多数情况下，家长的焦虑显然起到了重要作用。840名儿童由医生转诊至急诊科，其中652名（22.3%）由主管医生转诊，其中213名（32.7%）被值班医生送回家，值班医生认为无需治疗。在由不同急诊科送来的120名（4.1%）儿童中，95名（79.1%）住院治疗。医生将相当多无需干预的儿童转诊至急诊科的原因仍不清楚。事实上，他们的诊断在83%的病例中与值班医生的诊断一致。总之，很难想象需要特定结构来解决的诊断或治疗问题。将开展与本地区工作的医生的合作项目，以便在可能的情况下控制急诊科的入院人数。
