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急诊患者。

Patients Attending Emergency Departments.

机构信息

Department of General Practice/Primary Care, Hamburg University Medical School, Hamburg-Eppendorf.

出版信息

Dtsch Arztebl Int. 2017 Sep 29;114(39):645-652. doi: 10.3238/arztebl.2017.0645.

Abstract

BACKGROUND

The number of patients in emergency departments has risen steadily in recent years, with a particular increase in patients not requiring urgent treatment. The aim of this study is to characterize this group of patients with respect to their sociodemographic features, health status, and reasons for attending an emergency department.

METHODS

PiNo Nord is a cross-sectional observational study representing two full working weeks in five different hospitals. Patients were questioned in personal interviews, and medical diagnoses were documented. The data were analyzed with multivariate logistic regressions in mixed multilevel models. Predictors for the subjectively perceived treatment urgency were identified by stepwise backward selection.

RESULTS

The 1175 patients questioned had an average age of 41.8 years and 52.9% were male. 54.7% said the degree of their treatment urgency was low. 41.3% had visited the emergency department on their own initiative, 17.0% on the advice or referral of their primary care physician, and 8.0% on the advice or referral of a specialist. The strongest predictors for low subjective treatment urgency were musculoskeletal trauma (odds ratio [OR] 2.18), skin conditions (OR 2.15), and the momentary unavailability of a primary care physician (OR 1.70).

CONCLUSION

More than half of the patients do not think their condition requires urgent treatment and thus do not meet the definition of a medical emergency. Patients' reasons for visiting the emergency department are varied; aside from the treatment urgency of the health condition itself, the reason may lie in perceived structural circumstances and individual preferences.

摘要

背景

近年来,急诊科的患者数量稳步上升,尤其是不需要紧急治疗的患者数量有所增加。本研究旨在描述这组患者的社会人口学特征、健康状况以及就诊急诊科的原因。

方法

PiNo Nord 是一项横断面观察性研究,代表五个不同医院的两个完整工作周。对患者进行了个人访谈,并记录了医疗诊断。使用混合多层模型中的多变量逻辑回归分析数据。通过逐步向后选择确定主观感知治疗紧迫性的预测因素。

结果

接受调查的 1175 名患者平均年龄为 41.8 岁,其中 52.9%为男性。54.7%的人认为自己的治疗紧迫性程度较低。41.3%的人是主动就诊,17.0%是根据初级保健医生的建议或转诊,8.0%是根据专科医生的建议或转诊。低主观治疗紧迫性的最强预测因素是肌肉骨骼创伤(比值比 [OR] 2.18)、皮肤状况(OR 2.15)和初级保健医生暂时不可用(OR 1.70)。

结论

超过一半的患者认为自己的病情不需要紧急治疗,因此不符合医疗紧急情况的定义。患者就诊急诊科的原因多种多样;除了健康状况本身的治疗紧迫性外,原因可能还在于感知到的结构情况和个人偏好。

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