Müller Martin, Klingberg Karsten, Srivastava David, Exadaktylos Aristomenis K
Emergency Department, Bern University Hospital, Bern, Switzerland.
PLoS One. 2016 May 18;11(5):e0155423. doi: 10.1371/journal.pone.0155423. eCollection 2016.
Large-scale war-related migration to Switzerland and other European countries is currently challenging European health systems. Little is known about recent patterns and trends in Emergency Department (ED) consultations by Asylum Seekers (AS).
A retrospective single-centre analysis was performed of the data from all adult patients with the official status of "Asylum Seeker" or "Refugee" who consulted the ED of Bern University Hospital, Switzerland, between June 2012 and June 2015. Patient characteristics and clinical information, such as triage category, type of referral and discharge, violence-related injury and diagnostic group on discharge, were extracted from the computerised database or determined from the medical reports. Changes in categorical variables between the three studied years were described.
A total of 1,653 eligible adult patients were identified in the 3-year period. Between the first (06/12-06/13) and third periods (06/14-06/15), the number of presentations per year increased by about 45%. The AS came from 62 different nations, the most common countries being Eritrea (13%), Somalia (13%) and Syria (11%). The mean age was 33.3 years (SD 12.3) and two thirds (65.7%) were male. The proportion of women increased over time. Moreover the relative proportions shifted from patients between 20 and 50 years to patients of under 20 or over 60 years. Nearly two thirds of the patients were walk-in emergencies and this proportion increased over time. The mean triage score was 2.9 (SD 0.7), with more than 90% presenting as "urgent consultation". About half of the patients were treated for trauma (17.2%), infections (16.8%) or psychiatric problems (14.2%). Trauma was seen in a higher proportion of male than female patients. About 25% of the patients were admitted for in-hospital treatment.
The recent rise in AS in the population has lead to an increase in AS presenting to EDs. This changes the composition of ED patients and should raise awareness that changes in procedures may be needed. Infectious diseases and psychiatric problems remain a heavy burden for AS presenting in the ED. A trend towards an increasing proportion of walk-in patients to the ED could not be explained by this study. Further studies and surveillance are needed to investigate this trend.
目前，与大规模战争相关的移民潮涌入瑞士及其他欧洲国家，这对欧洲的医疗系统构成了挑战。对于寻求庇护者（AS）在急诊科（ED）就诊的近期模式和趋势，我们知之甚少。
对2012年6月至2015年6月期间在瑞士伯尔尼大学医院急诊科就诊的所有具有“寻求庇护者”或“难民”官方身份的成年患者的数据进行回顾性单中心分析。从计算机数据库中提取患者特征和临床信息，如分诊类别、转诊和出院类型、与暴力相关的伤害以及出院时的诊断组，或从医疗报告中确定这些信息。描述了三个研究年份之间分类变量的变化。
在3年期间共识别出1653名符合条件的成年患者。在第一个时期（2012年6月至2013年6月）和第三个时期（2014年6月至2015年6月）之间，每年的就诊人数增加了约45%。这些寻求庇护者来自62个不同的国家，最常见的国家是厄立特里亚（13%）、索马里（13%）和叙利亚（11%）。平均年龄为33.3岁（标准差12.3），三分之二（65.7%）为男性。女性的比例随时间增加。此外，相对比例从20至50岁的患者转向了20岁以下或60岁以上的患者。近三分之二的患者为非预约急诊，且这一比例随时间增加。平均分诊分数为2.9（标准差0.7），超过90%的患者表现为“紧急会诊”。约一半的患者因创伤（17.2%）、感染（16.8%）或精神问题（14.2%）接受治疗。男性患者中因创伤就诊的比例高于女性患者。约25%的患者被收治住院治疗。
近期寻求庇护者在人口中的增加导致了到急诊科就诊的寻求庇护者人数上升。这改变了急诊科患者的构成，应提高人们对可能需要改变程序的认识。传染病和精神问题仍然是在急诊科就诊的寻求庇护者的沉重负担。本研究无法解释非预约患者到急诊科就诊比例增加的趋势。需要进一步的研究和监测来调查这一趋势。
