Koonin Lisa M, Hanfling Dan
Pandemic Medical Care and Countermeasures Task Force, Influenza Coordination Unit, Office of Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
Biosecur Bioterror. 2013 Mar;11(1):75-80. doi: 10.1089/bsp.2013.0012. Epub 2013 Mar 4.
The impact of a severe influenza pandemic could be overwhelming to hospital emergency departments, clinics, and medical offices if large numbers of ill people were to simultaneously seek care. While current planning guidance to reduce surge on hospitals and other medical facilities during a pandemic largely focuses on improving the "supply" of medical care services, attention on reducing "demand" for such services is needed by better matching patient needs with alternative types and sites of care. Based on lessons learned during the 2009 H1N1 pandemic, the Centers for Disease Control and Prevention and its partners are currently exploring the acceptability and feasibility of using a coordinated network of nurse triage telephone lines during a pandemic to assess the health status of callers, help callers determine the most appropriate site for care (eg, hospital ED, outpatient center, home), disseminate information, provide clinical advice, and provide access to antiviral medications for ill people, if appropriate. As part of this effort, the integration and coordination of poison control centers, existing nurse advice lines, 2-1-1 information lines, and other hotlines are being investigated.
如果大量患病人员同时寻求治疗，严重流感大流行对医院急诊科、诊所和医务室的影响可能是压倒性的。虽然目前关于在大流行期间减少医院和其他医疗设施压力的规划指南主要侧重于改善医疗服务的“供应”，但需要通过更好地将患者需求与替代类型和护理地点相匹配来关注减少对此类服务的“需求”。根据2009年甲型H1N1流感大流行期间吸取的经验教训，疾病控制和预防中心及其合作伙伴目前正在探索在大流行期间使用护士分诊电话线协调网络的可接受性和可行性，以评估来电者的健康状况，帮助来电者确定最合适的护理地点（如医院急诊科、门诊中心、家中），传播信息，提供临床建议，并在适当时为患病人员提供抗病毒药物。作为这项工作的一部分，正在研究毒物控制中心、现有护士咨询热线、2-1-1信息热线和其他热线的整合与协调。
