儿科炎症性肠病中急诊科使用的适宜性：一个质量改进的契机。
Appropriateness of emergency department use in pediatric inflammatory bowel disease: a quality improvement opportunity.
作者信息
Hoffenberg Edward J, Park K T, Dykes Dana M, Fridge Jacqueline, Kappelman Michael D, Leibowitz Ian H, Tsou V Marc, Colletti Richard B
机构信息
*Digestive Health Institute, Children's Hospital Colorado and Department of Pediatrics, University of Colorado School of Medicine, Aurora †Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California ‡Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Medical Center, Cincinnati, Ohio §Northwest Pediatric Gastroenterology LLC, Randall Children's Hospital, Portland, Oregon ||Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill ¶Children's Digestive Disease Program, Pediatric Digestive Diseases, Inova Fairfax Hospital for Children, Fairfax, Virginia #Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Eastern Virginia Medical School, Children's Specialty Group, Norfolk **University of Vermont College of Medicine, Burlington.
出版信息
J Pediatr Gastroenterol Nutr. 2014 Sep;59(3):324-6. doi: 10.1097/MPG.0000000000000457.
OBJECTIVES
We sought to characterize emergency department (ED) encounters for pediatric inflammatory bowel disease (IBD) to identify areas for prevention.
METHODS
Retrospective chart review of 5 consecutive ED encounters at 7 centers was performed.
RESULTS
Of 35 unique encounters by 32 patients, 3 main factors contributed to ED utilization: disease severity or course, day or time of care, and physician instruction. Of the ED encounters, approximately one-fifth were judged medically unnecessary, and one-half avoidable in a more optimal health care system.
CONCLUSIONS
ED visits by pediatric patients with IBD may be reduced in a more optimal health care system.
目的
我们试图描述儿科炎症性肠病（IBD）患者在急诊科（ED）的就诊情况，以确定预防领域。
方法
对7个中心连续5次ED就诊情况进行回顾性病历审查。
结果
32例患者的35次独特就诊中，导致ED就诊的主要因素有3个：疾病严重程度或病程、就诊日期或时间以及医生指示。在这些ED就诊中，约五分之一被判定为医疗上不必要，在更优化的医疗系统中，约一半是可避免的。
结论
在更优化的医疗系统中，IBD儿科患者的ED就诊次数可能会减少。
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