Stene-Larsen G, Hagen H
Tidsskr Nor Laegeforen. 1989 Feb 20;109(5):545-8.
The number of transferrals between Oslo hospitals has been doubled since the hospital system was regionalized in 1982. Essentially, this development may be explained by the increased need to refer patients to the highly specialized hospitals because of recent years advances in medical technology. During a two month period in 1988, 4,841 admissions to hospitals in Oslo were registered, and 917 transferrals between hospitals. We found that patient-transport was adequate in 92% of the cases. However, ambulance personnel reported 389 cases (8%) of delayed admissions and unnecessary transferrals between the hospitals. In most cases, the real cause of the problems was a too rigid attitude among health workers. The inflexibility of the present system seems to be a major threat to the principle of regionalization. We propose a simple set of rules which will protect the principle and also the requests of the patients.
自1982年医院系统实行区域化以来，奥斯陆各医院之间的转诊数量增加了一倍。从本质上讲，这一发展可以解释为由于近年来医疗技术的进步，将患者转诊至高度专业化医院的需求增加。1988年的两个月时间里，奥斯陆各医院共登记了4841例入院病例，以及917例医院之间的转诊。我们发现，92%的病例中患者转运情况良好。然而，救护人员报告了389例（8%）延迟入院和医院之间不必要的转诊情况。在大多数情况下，问题的真正原因是医护人员态度过于僵化。现行系统的不灵活性似乎对区域化原则构成了重大威胁。我们提出了一套简单的规则，既能保护这一原则，又能满足患者的需求。
