St. Vincent's University Hospital, Department of Emergency Medicine, Dublin, Ireland.
West J Emerg Med. 2009 Nov;10(4):233-9.
Emergency department (ED) crowding is a multifactorial problem, resulting in increased ED waiting times, decreased patient satisfaction and deleterious domino effects on the entire hospital. Although difficult to define and once limited to anecdotal evidence, crowding is receiving more attention as attempts are made to quantify the problem objectively. It is a worldwide phenomenon with regional influences, as exemplified when analyzing the problem in Europe compared to that of the United States. In both regions, an aging population, limited hospital resources, staff shortages and delayed ancillary services are key contributors; however, because the structure of healthcare differs from country to country, varying influences affect the issue of crowding. The approach to healthcare delivery as a right of all people, as opposed to a free market commodity, depends on governmental organization and appropriation of funds. Thus, public funding directly influences potential crowding factors, such as number of hospital beds, community care facilities, and staffing. Ultimately ED crowding is a universal problem with distinctly regional root causes; thus, any approach to address the problem must be tailored to regional influences.
急诊科（ED）拥挤是一个多因素的问题，导致 ED 等待时间延长，患者满意度降低，并对整个医院产生有害的多米诺骨牌效应。尽管拥挤现象难以定义，且曾经仅限于轶事证据，但随着人们试图客观地量化这一问题，它正受到更多关注。这是一个全球性现象，具有区域性影响，例如在分析欧洲与美国的问题时就可以看到这一点。在这两个地区，人口老龄化、医院资源有限、人员短缺和辅助服务延迟都是主要因素；然而，由于医疗保健的结构因国家而异，因此不同的因素会影响拥挤问题。将医疗保健作为所有人的权利而不是自由市场商品提供的方式，取决于政府的组织和资金分配。因此，公共资金直接影响潜在的拥挤因素，如医院床位、社区护理设施和人员配备数量。最终，急诊科拥挤是一个普遍存在的问题，具有明显的区域性根源；因此，任何解决问题的方法都必须针对区域性影响进行调整。
