Bertazzoni G, Cristofani M, Ponzanetti A, Trabalzini A, Attalla H, De Vito C, Villari P
Emergency Department, Policlinico Umberto I Rome, Via del Policlinico 155, 00161 Rome, Italy.
Emerg Med J. 2008 Sep;25(9):558-61. doi: 10.1136/emj.2007.052415.
Interhospital transfers are one of the critical points of the emergency system, which often cause overcrowding of the emergency department (ED) and limit its effectiveness.
A retrospective study was carried out, analyzing the clinical case files concerning the ED of the Policlinico "Umberto I" in Rome (Latium region, Italy) with the aim of establishing the reasons for the numerous unjustified transfers.
From 1 January to 30 June 2006, 77 597 admissions to the ED occurred, and 861 patients (1.1%) were sent from other hospitals. 361 patients out of 861 (41.9%) were transferred with critical clinical conditions. The remaining 500 patients (58.1%) were transferred requiring specialised care. The need for specialised care was confirmed in 230 cases (46.0%) and therefore these transfers could be considered justified. The other 270 transfers (54.0%) were unjustified: 138 patients remained in the hospital to which they had been sent, contributing to crowding of the ED; 132 patients were returned, thereby placing them at additional risk.
Unfamiliarity with the regulations governing interhospital transfers is the main cause of scantly justified transfers and the consequent reduction in efficiency of the ED in the receiving hospital.
医院间转运是急救系统的关键点之一，常导致急诊科过度拥挤并限制其效率。
开展一项回顾性研究，分析罗马“翁贝托一世”综合医院（意大利拉齐奥地区）急诊科的临床病例档案，目的是确定大量不合理转运的原因。
2006年1月1日至6月30日，急诊科共收治77597例患者，其中861例（1.1%）由其他医院送来。861例患者中有361例（41.9%）在临床病情危急时被转运。其余500例患者（58.1%）因需要专科护理而被转运。230例（46.0%）患者的专科护理需求得到确认，因此这些转运可被视为合理。另外270例转运（54.0%）不合理：138例患者留在了被送往的医院，加剧了急诊科的拥挤；132例患者被送回，从而使他们面临额外风险。
不熟悉医院间转运的相关规定是转运合理性不足以及接收医院急诊科效率降低的主要原因。
