Hodkinson P W, Wallis L A
Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.
Emerg Med J. 2009 Sep;26(9):635-40. doi: 10.1136/emj.2008.063362.
To describe the demographics, referral mechanism and outcome of the emergency consultation in patients presenting to a secondary hospital emergency centre (EC).
An observational study of patients presenting to an EC in a 1-month period from 19 November to 20 December 2007.
New Somerset Hospital, Cape Town, South Africa.
All patients presenting alive to the EC during the study period who were seen by an EC doctor.
A data collection form was completed by EC doctors at the time of the initial EC consultation documenting patient demographics, time and delay periods, South African Triage Score (SATS), initial diagnosis, transport and referral mechanisms and outcome of EC consultation.
Data on 2646 patient presentations were described with a mix of SATS acuity levels (green: routine care; yellow: urgent; orange: very urgent; red: immediate), with more than one-third of presentations scoring an orange or red SATS. Most patients presented in the daytime, with an increase in more ill patients (higher SATS) later in the day and at night. The peak age group was 20-40 years, with 39% resident in informal settlements within 15 km of the hospital. The initial diagnosis was trauma in 26% of presentations, with a wide spread of other presentations. Patients were transported by ambulance to the EC in 39% of presentations, 41% were self-referred and 41% were referred by a primary health care practitioner. Fifty-three percent of presentations were either admitted to hospital or kept in the EC for further investigations, and the remainder were discharged from the EC.
Clear trends are seen for patient demographics and temporal attendance patterns which are important for resource allocation and planning. Many low-acuity patients, largely non-referred, are being seen in the EC and should be managed by primary health care level staff outside the EC.
描述前往二级医院急诊科（EC）就诊患者的人口统计学特征、转诊机制及急诊会诊结果。
对2007年11月19日至12月20日这1个月期间前往急诊科就诊的患者进行观察性研究。
南非开普敦新萨默塞特医院。
研究期间所有活着到达急诊科并由急诊科医生诊治的患者。
急诊科医生在首次急诊会诊时填写一份数据收集表，记录患者的人口统计学特征、时间和延迟时间、南非分诊评分（SATS）、初步诊断、转运和转诊机制以及急诊会诊结果。
描述了2646例患者就诊的数据，SATS acuity水平各异（绿色：常规护理；黄色：紧急；橙色：非常紧急；红色：立即），超过三分之一的就诊患者SATS评分为橙色或红色。大多数患者在白天就诊，病情较重的患者（SATS评分较高）在当天晚些时候和夜间有所增加。年龄峰值组为20 - 40岁，39%的患者居住在距离医院15公里内的非正式定居点。26%的就诊患者初步诊断为创伤，其他诊断分布广泛。39%的就诊患者由救护车转运至急诊科，41%为自我转诊，41%由初级医疗保健从业者转诊。53%的就诊患者入院或留在急诊科进行进一步检查，其余患者从急诊科出院。
患者人口统计学特征和就诊时间模式呈现出明显趋势，这对资源分配和规划很重要。许多低急症患者在急诊科就诊，且大多未经转诊，这些患者应由急诊科以外的初级医疗保健人员管理。
