Brody A M, Murphy E, Flack J M, Levy P D
Department of Emergency Medicine, Wayne State University School of Medicine, Detroit Medical Centre, UHC Suite 6G, 4201 St Antoine St, Detroit, Michigan, 48201, USA.
Division of Translational Research and Clinical Epidemiology; Department of Medicine; Cardiovascular Research Institute, Wayne State University, Detroit, Michigan, USA.
West Indian Med J. 2014 Jun;63(3):234-7. doi: 10.7727/wimj.2013.332. Epub 2014 Jun 11.
With rising patient volumes and increasingly complex cases, the specialty of emergency medicine faces a growing array of challenges. Efforts have been made to improve patient throughput, yet little attention has been directed to the increasing amount of primary care delivered in emergency departments (EDs) for chronic disease states such as hypertension and diabetes. Management of chronic medical conditions is traditionally seen as beyond the purview of the ED and emergency physicians tend to defer critical aspects of related patient care to other components of the healthcare continuum. As a result, vulnerable patients are often forced to navigate exceedingly complex and fragmented systems of care with little guidance, which often leads to inadequate treatment and exposure to increased risk for development of potentially avoidable complications. As evidenced by our experience with hypertension in an under resourced community, there is a crucial need for emergency physicians to espouse their role as providers of healthcare across the acuity spectrum and lead the way in defining regionally relevant solutions to better manage patients with chronic medical problems.
随着患者数量的增加和病例日益复杂，急诊医学专业面临着越来越多的挑战。人们已努力提高患者周转率，但对于急诊科为高血压和糖尿病等慢性病提供的初级护理量不断增加这一情况，却很少有人关注。慢性病管理传统上被认为超出了急诊科的范畴，急诊医生往往会将相关患者护理的关键方面推迟到医疗保健连续体的其他部分。结果，弱势患者常常被迫在几乎没有指导的情况下，在极其复杂和分散的护理系统中艰难前行，这往往导致治疗不足，并面临出现潜在可避免并发症的风险增加。正如我们在资源匮乏社区处理高血压问题的经验所表明的那样，急诊医生迫切需要承担起其作为全 acuity 范围内医疗服务提供者的角色，并带头确定区域相关的解决方案，以更好地管理患有慢性疾病的患者。
