Avitzour Malka, Aharonson-Daniel Limor, Peleg Kobi
Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel.
Isr Med Assoc J. 2006 Aug;8(8):539-42.
Trauma systems were created in order to provide optimal care for trauma patients. Hence, patients transferred to level I trauma centers are assumed to be transferred due to medical reasons as a result of complex injuries.
To explore the reasons for transfer of patients from regional to level I trauma centers in Israel as a basis for establishing a national policy regarding transfers.
The data on patients transferred to five level I trauma centers during a 6 month period were collected using a structured form.
The study population comprised 929 patients transferred from regional hospitals. Most transfers were due to the need for a specialty unavailable at the first hospital (65%) or for special diagnostic equipment (3% in Jews, 23% in Arabs). Only 3.6% of the transferred patients were transferred because of multi-system injury. Some casualties were transferred following their own request, 26% Jews and 3% Arabs.
Most patient transfers concur with the recommendations of the Ministry of Health, namely, the absence of a certain specialty or equipment. The fact that many of the transfers reflect a lack of available resources at the first evacuation destination suggests that increasing the availability of these resources can help reduce secondary triage. It is recommended that a cost-benefit analysis be conducted.
创伤系统的建立是为了给创伤患者提供最佳治疗。因此，转至一级创伤中心的患者被认为是由于复杂损伤的医疗原因而被转院。
探究以色列患者从地区医院转至一级创伤中心的原因，作为制定全国转院政策的依据。
使用结构化表格收集6个月期间转至5个一级创伤中心的患者数据。
研究人群包括929名从地区医院转来的患者。大多数转院是因为一级医院没有所需的专科服务（65%）或特殊诊断设备（犹太人中占3%，阿拉伯人中占23%）。只有3.6%的转院患者是因为多系统损伤而转院。一些伤员是应自身要求转院的，犹太人中有26%，阿拉伯人中有3%。
大多数患者转院符合卫生部的建议，即缺乏特定专科服务或设备。许多转院情况反映出首个疏散目的地缺乏可用资源，这表明增加这些资源的可及性有助于减少二次分诊。建议进行成本效益分析。
