定义“高频”急诊科就诊：城市和农村是否一概而论？
Defining "high-frequency" emergency department use: Does one size fit all for urban and rural areas?
机构信息
Epidemiologist with the Sioux Lookout First Nations Health Authority in Ontario.
Assistant Professor in the Division of Clinical Sciences at the Northern Ontario School of Medicine in Sioux Lookout.
出版信息
Can Fam Physician. 2017 Sep;63(9):e395-e399.
OBJECTIVE
To suggest a functional definition for identification of "high-frequency" emergency department (ED) users in rural areas.
DESIGN
Retrospective analysis of secondary data.
SETTING
Sioux Lookout Meno Ya Win Health Centre in northwestern Ontario.
PARTICIPANTS
All ED visitors (N = 7121) in 2014 (N = 17 911 visits) in one rural hospital.
MAIN OUTCOME MEASURES
The number of patients and visits identified using different definitions of RESULTS: By using the most common definition of high-frequency use (≥ 4 annual visits) for our hospital data, we identified 16.7% of ED patients. Using 6 or more annual visits as the definition, we identified 7.9% of ED patients; these patients accounted for 31.3% of the ED visit workload. Using the definition of 6 or more identifies less than 10% of the patients, which is a similar result to using the lower visit standard (≥ 4) in urban centres.
CONCLUSION
We suggest that the definition for high-frequency visitors to a rural ED should be 6 or more annual visits. Other useful subsets might include very high-frequency users (12 to 19 annual visits) and super users (≥ 20 annual visits).
目的
为农村地区的“高频”急诊科（ED）使用者确定一个功能定义。
设计
二次数据的回顾性分析。
地点
安大略省西北部的 Sioux Lookout Meno Ya Win 健康中心。
参与者
2014 年（17911 次就诊）一家农村医院所有 ED 访客（N=7121）。
主要观察指标
使用不同的高频使用定义识别出的患者数量和就诊次数。
结果
使用我们医院数据中最常见的高频使用定义（≥4 次就诊），我们确定了 16.7%的 ED 患者。使用 6 次或更多的年度就诊作为定义，我们确定了 7.9%的 ED 患者；这些患者占 ED 就诊工作量的 31.3%。使用 6 次或更多次就诊的定义识别出的患者不到 10%，这与在城市中心使用较低的就诊标准（≥4）相似。
结论
我们建议农村 ED 的高频就诊者的定义应为 6 次或更多次就诊。其他有用的子集可能包括非常高频就诊者（12 至 19 次就诊）和超级高频就诊者（≥20 次就诊）。
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