Selasawati H G, Naing L, Wan Aasim W A, Winn T, Rusli B N
Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia.
Med J Malaysia. 2004 Mar;59(1):26-33.
Inappropriate utilization of Emergency Departments (ED) services may result in compromised management of patients requiring true emergency treatment. Significant attendance of non-emergency cases in ED was found in several countries. A cross-sectional study was conducted in Universiti Sains Malaysia Hospital (HUSM) to determine the proportion of the inappropriate cases and the utilization pattern by time (over 24 hours and within a week) and by diagnoses. A sample of 350 cases was randomly selected from ED-HUSM register of the year 2000. A decision flowchart, which was adopted from 4 guidelines, was applied to classify appropriate and inappropriate cases. There were 55% inappropriate cases in this study. The inappropriate cases increased considerably in early morning, late evening, during the weekend and early part of the week. Most common diagnoses of inappropriate cases were upper respiratory tract infections, mild acute gastroenteritis and urinary tract infections. Considerable attendance of inappropriate cases calls for interventions.
急诊科（ED）服务的不当使用可能会导致需要真正紧急治疗的患者的管理受到影响。在几个国家都发现有大量非紧急病例前往急诊科就诊。在马来西亚理科大学医院（HUSM）进行了一项横断面研究，以确定不当病例的比例以及按时间（超过24小时和一周内）和诊断分类的使用模式。从HUSM急诊科2000年的登记记录中随机抽取了350个病例样本。采用了源自4项指南的决策流程图来对适当和不适当的病例进行分类。本研究中有55%的病例属于不当病例。不当病例在清晨、深夜、周末和一周的早些时候显著增加。不当病例最常见的诊断是上呼吸道感染、轻度急性肠胃炎和尿路感染。大量不当病例的就诊情况需要采取干预措施。
