埃塞俄比亚亚的斯亚贝巴一家三级医院的急诊外科患者转诊情况

REFERRAL OF EMERGENCY SURGICAL PATIENTS IN A TERTIARY HOSPITAL, ADDIS ABABA, ETHIOPIA.

作者信息

Abebe Engida, Teshome Henok, Bekele Mahteme

出版信息

Ethiop Med J. 2016 Oct;54(4):221-8.

Abstract

INTRODUCTION

Referral is part of patient care when done appropriately. Common reasons for referral include seeking expert advice, technical examination and/or intervention, care beyond the facility’s capacity. Objectives: Determine the rate, reason for and type of cases referred among patients seen at surgical Emergency Room of SPHMMC during May to July 2015.

PATIENTS AND METHODS

Cross sectional study was done at St. Paul’s Hospital Millennium Medical College Emergency Room, including all surgical patients seen in three months period. Data was collected from the individual patient’s medical records, records of the ER and the liaison office and Interns morning reporting book. Data was analyzed with SPSS version 20.

RESULTS

Total of 2,492 patients were seen. The mean number of patients seen per day was 27.7 with a range from 13 to 51. Trauma made 70% (1746) of all cases seen. Cases that needed admission made 30.1% (755), but only 49.5 % (374) of them were admitted. The overall referral rate was 15.3%. The referral rate in patients who needed admission was 50.5 % (381). Trauma made 77.4% (295) of the referrals, mainly orthopedic, 54.6% (161) and neuro-traumas, 38% (112). Among non trauma cases acute abdominal conditions tops, 75% (56). Lack of inpatient beds was the main reason for referral 65.6% (250). Specialist care need was the reason for referral in 34.5% (131) of cases. Among patients referred only 14.4% (55) left the hospital at the time of referrals. Four percent (13) of the kept patients died in the ER waiting for referrals.

CONCLUSIONS

The rate of referral from St. Paul’s Hospital Millennium Medical College Emergency Room is high. It is higher in trauma cases, specifically orthopedic and neuro-traumas. Main reason for referrals was lack of bed. The capacity of the hospital and other hospitals in AA in absorbing traumas, specifically orthopedic and neurotraumas need to be evaluated and necessary policy adjustments should be implemented. Further study at each hospital and the whole city gives better picture of referrals among hospitals in Addis Ababa.

摘要

引言

在操作适当时，转诊是患者护理的一部分。转诊的常见原因包括寻求专家建议、进行技术检查和/或干预、超出医疗机构能力范围的护理。目的：确定2015年5月至7月在SPHMMC外科急诊室就诊的患者中转诊病例的发生率、原因和类型。

患者与方法

在圣保罗医院千禧医学院急诊室进行横断面研究，纳入三个月期间所有外科患者。数据从个体患者病历、急诊室记录、联络办公室记录以及实习医生早报本中收集。使用SPSS 20版软件进行数据分析。

结果

共诊治2492例患者。每日平均就诊患者数为27.7例，范围为13至51例。创伤病例占所有就诊病例的70%（1746例）。需要住院的病例占30.1%（755例），但其中仅49.5%（374例）被收治。总体转诊率为15.3%。需要住院患者的转诊率为50.5%（381例）。创伤病例占转诊病例的77.4%（295例），主要是骨科创伤，占54.6%（161例）和神经创伤，占38%（112例）。在非创伤病例中，急腹症居首，占75%（56例）。缺乏住院床位是转诊的主要原因，占65.6%（250例）。34.5%（131例）的病例转诊原因是需要专科护理。在转诊患者中，仅14.4%（55例）在转诊时离院。4%（13例）留院患者在急诊室等待转诊期间死亡。