School of Public Health, Queensland University of Technology, Brisbane, Australia/Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.
World J Emerg Med. 2010;1(3):180-4.
This study aimed to make a preliminary comparison of emergency department (ED) presentations between Australia and China. The comparison could provide insights into the health systems and burden of diseases and potentially stimulate discussion about the development of acute health system in China.
An observational study was performed to compare Australian ED presentations using data obtained from a single adult tertiary-referral teaching hospital in metropolitan Brisbane against Chinese ED presentations using public domain information published in existing Chinese and international medical journals.
There are major differences in ED presentations between Australia and China. In 2008, 1) 35.4% of patients arrived at a tertiary teaching hospital ED in Brisbane, Australia by ambulance; 2) 1.7% were treated for poisoning; 3) 1.4% for cerebral vascular disease; 4) 1.7% for cardiac disease; and 5) 42.6% for trauma. The top events diagnosed were mental health problems including general psychiatric examination, psychiatric review, alcohol abuse, and counselling for alcohol abuse, which accounted for 5.5% of all ED presentations. Among ED patients in China, 6.7% arrived at a tertiary teaching hospital by ambulance in Shenyang in 1997; 3.7% were treated for poisoning in Shanxi Zhouzhi County People's Hospital ED in 2006; 14.9% for cerebral vascular diseases at Qinghai People's Hospital ED in 1993-1995; 1.7% for cardiac diseases at the Second People's Hospital ED, Shenzhen Longgang in 1993; and 44.3% for trauma at Shanxi Zhouzhi County People's Hospital ED in 2006. The top events were trauma and poisoning among the young and cerebral infarction in the older population.
Compared with Australian, Chinese ED patients had 1) lower ambulance usage; 2) higher proportion of poisoning; 3) higher proportion of cerebral vascular diseases; 4) similar proportion of cardiac disease; 5) similar proportion of trauma; and 6) little reported mental health problems. Possible explanations for these differences in China include a pay for service pre-hospital care system, lack of public awareness about poisons, inadequate hypertension management, and lack of recognition of mental health problems.
本研究旨在对中澳两国急诊科就诊情况进行初步比较。这种比较可以深入了解中澳两国的卫生系统和疾病负担，同时可能会引发对中国急性卫生系统发展的讨论。
本研究采用观察性研究方法，利用澳大利亚布里斯班一家成人三级转诊教学医院获得的数据，与中国和国际医学期刊发表的公开信息进行对比，对中国急诊科就诊情况进行了比较。
澳大利亚和中国急诊科就诊情况存在显著差异。2008 年，1）在澳大利亚布里斯班的一家三级教学医院急诊科，35.4%的患者通过救护车到达；2）1.7%的患者因中毒接受治疗；3）1.4%的患者因脑血管疾病接受治疗；4）1.7%的患者因心脏病接受治疗；5）42.6%的患者因创伤接受治疗。在急诊科就诊的患者中，诊断最多的是心理健康问题，包括一般精神检查、精神科复查、酒精滥用和酒精滥用咨询，占所有急诊科就诊患者的 5.5%。1997 年，沈阳的一家三级教学医院中，6.7%的患者通过救护车到达；2006 年，山西周至县人民医院急诊科 3.7%的患者因中毒接受治疗；1993-1995 年，青海人民医院急诊科 14.9%的患者因脑血管疾病接受治疗；1993 年，深圳龙岗区第二人民医院急诊科 1.7%的患者因心脏病接受治疗；2006 年，山西周至县人民医院急诊科 44.3%的患者因创伤接受治疗。就诊的主要疾病是年轻人的创伤和中毒以及老年人的脑梗死。
与澳大利亚相比，中国急诊科就诊患者的情况为：1）救护车使用率较低；2）中毒比例较高；3）脑血管疾病比例较高；4）心脏病比例相似；5）创伤比例相似；6）心理健康问题报道较少。造成这些差异的原因可能包括按服务付费的院前急救系统、公众对毒物的认识不足、高血压管理不足以及心理健康问题的认识不足。
