Genell Andrén K
Department of Social Work, St Göran's Hospital, Stockholm, Sweden.
Scand J Soc Med. 1988;16(2):87-93. doi: 10.1177/140349488801600205.
Several studies have shown that persons who repeatedly turn to somatic emergency departments, besides having ailments also often have social and psychological problems. It has also been shown that this group of patients differs from the general population and can be considered a psycho-socially exposed group. In the present study a group of recurrent users (4 + yearly visits) was compared to a group of first-time visitors to the general emergency department of a middlesized metropolitan hospital. Both patient groups were asked to complete a questionnaire that contained 45 items, covering socio-demographic and social network variables, social and personal problems, perceived state of health and contacts with other care-giving institutions. The results showed that the first-time visitors were significantly younger than the recurrent users, and more often actively employed. Only 2 percent of the first-time visitors developed a behaviour of recurrent use of the ED. The recurrent users were well-known at the hospital, not only in the emergency department but also at the out-patient clinics and the social work department. The multiple Odds ratio showed that alcohol abuse, lack of close friend, general health problems and deteriorating health were important risk factors for recurrent ED use. It is suggested that an individual treatment plan including medical, social and societal measures could be one alternative in an attempt to more efficiently treat these patients.
多项研究表明，那些反复前往躯体急诊科室的人，除了患有疾病外，往往还存在社会和心理问题。研究还表明，这类患者与普通人群不同，可以被视为一个社会心理暴露群体。在本研究中，将一组复发使用者（每年就诊4次以上）与一组首次前往一家中型都市医院普通急诊科就诊的患者进行了比较。两组患者都被要求填写一份包含45个条目的问卷，内容涵盖社会人口统计学和社会网络变量、社会和个人问题、感知健康状况以及与其他护理机构的接触情况。结果显示，首次就诊者明显比复发使用者年轻，且更常处于就业状态。只有2%的首次就诊者出现了反复使用急诊科的行为。复发使用者在医院广为人知，不仅在急诊科，在门诊诊所和社会工作部门也是如此。多重优势比表明，酒精滥用、缺乏亲密朋友、一般健康问题和健康状况恶化是反复使用急诊科的重要风险因素。建议制定一个包括医疗、社会和社会措施的个体化治疗方案，这可能是更有效治疗这些患者的一种选择。
