Hugli O W, Potin M, Schreyer N, Yersin B
Centre interdisciplinaire des urgences CHUV, 1011 Lausanne.
Rev Med Suisse. 2006 Aug 9;2(75):1836-9.
Non-urgent cases represent 30-40% of all ED consults; they contribute to overcrowding of emergency departments (ED), which could be reduced if they were denied emergency care. However, no triage instrument has demonstrated a high enough degree of accuracy to safely rule out serious medical conditions: patients suffering from life-threatening emergencies have been inappropriately denied care. Insurance companies have instituted financial penalties to discourage the use of ED as a source of non-urgent care, but this practice mainly restricts access for the underprivileged. More recent data suggest that in fact most patients consult for appropriate urgent reasons, or have no alternate access to urgent care. The safe reduction of overcrowding requires a reform of the healthcare system based on patients' needs rather than access barriers.
非紧急情况占所有急诊科会诊病例的30%至40%；它们导致急诊科过度拥挤，如果拒绝为这些病例提供紧急护理，拥挤情况可能会得到缓解。然而，没有一种分诊工具能够证明其准确性足以安全地排除严重疾病：患有危及生命紧急情况的患者被不恰当地拒绝了护理。保险公司已实施经济处罚措施，以劝阻人们将急诊科用作非紧急护理的来源，但这种做法主要限制了弱势群体的就医机会。最新数据表明，实际上大多数患者就诊是出于适当的紧急原因，或者没有其他途径获得紧急护理。要安全地缓解过度拥挤，需要根据患者需求而非就医障碍对医疗保健系统进行改革。
