Burchard Rene, Oikonomoulas Vasileios, Soost Christian, Zoremba Martin, Graw Jan Adriaan
Department of Health, University of Witten/Herdecke, Witten, Germany; Department of Trauma and Orthopaedic Surgery, Kreisklinikum Siegen, Siegen, Germany; School of Science and Technology, University of Siegen, Siegen, Germany.
Department of Trauma and Orthopaedic Surgery, Kreisklinikum Siegen, Siegen, Germany.
Int Emerg Nurs. 2019 May;44:30-34. doi: 10.1016/j.ienj.2019.02.006. Epub 2019 Apr 17.
Patient visits to emergency departments (EDs) increase in many countries. As a result, these facilities are often congested and the socioeconomic burden of growing workload is a well-known problem. In this study, patients' reasons attending an ED with non-emergent needs were analyzed.
From October 2015 to March 2016 patients (n = 499), attending the ED of an academic teaching hospital without referral from a General Practitioner (GP) were surveyed regarding circumstances of their visit, a self-assessment of illness-severity, and reasons for choosing the ED instead of a GP. Results were compared to responses of ED staff (n = 40).
Most patients assessed their case as urgent (patients: 65% vs. ED staff: 28%, p < 0.001) and felt that their medical problem could not to be treated by a GP (74%). However, most patients ranked their injuries as mild (45.7%) or moderate (41.7%). Reasons to prefer an ED instead of a GP were not responded in 80.1% of cases.
In contrast to the self-evaluation of patients, ED staff believed that a significant portion of medical problems could be treated by a GP. Understanding patient-centred reasons and the discrepancy between self-perceived emergencies and minor medical problems might help to reduce inappropriate ED-admissions.
在许多国家，患者前往急诊科就诊的人数有所增加。因此，这些科室常常人满为患，工作量不断增加所带来的社会经济负担是一个众所周知的问题。在本研究中，对患者前往急诊科就诊但需求并非紧急的原因进行了分析。
2015年10月至2016年3月，对一所学术教学医院急诊科的499名未由全科医生（GP）转诊的患者就就诊情况、自我评估的疾病严重程度以及选择急诊科而非全科医生的原因进行了调查。将结果与40名急诊科工作人员的回答进行了比较。
大多数患者将自己的情况评估为紧急（患者：65%，急诊科工作人员：28%，p<0.001），并认为自己的医疗问题无法由全科医生治疗（74%）。然而，大多数患者将自己的伤势评为轻度（45.7%）或中度（41.7%）。在80.1%的病例中，未对选择急诊科而非全科医生的原因作出回应。
与患者的自我评估相反，急诊科工作人员认为很大一部分医疗问题可由全科医生治疗。了解以患者为中心的原因以及自我感知的紧急情况与轻微医疗问题之间的差异可能有助于减少不适当的急诊科入院情况。
