Buesching D P, Jablonowski A, Vesta E, Dilts W, Runge C, Lund J, Porter R
Ann Emerg Med. 1985 Jul;14(7):672-6. doi: 10.1016/s0196-0644(85)80886-6.
Guidelines adopted in 1982 by the American College of Emergency Physicians were used to determine appropriate and inappropriate emergency department (ED) utilization patterns at three community hospitals during a two-week period in August 1983. In all, 3,130 visits were examined. There was an overall inappropriate visit rate of 10.8%, although considerable variation was observed among the three hospitals. Subgroups with the highest inappropriate visit rates included the following: 1) persons with Medicaid as the primary payment source (17.3%); 2) children aged 5 years or younger (15.2%); 3) those unable to identify a personal physician (14.1%); 4) unemployed persons (13.1%); 5) patients making visits during regular office hours (12.6%); and 6) those failing to attempt to contact their personal physicians (12.4%). These variations in inappropriate usage were all statistically significant at the P less than .05 level or better. Inability to identify a personal physician emerged as the most pervasive influence on inappropriate ED visit rates (P less than .001).
美国急诊医师学会1982年采用的指南被用于确定1983年8月为期两周的时间里，三家社区医院急诊科（ED）的合理与不合理使用模式。总共检查了3130次就诊情况。总体不合理就诊率为10.8%，不过三家医院之间存在显著差异。不合理就诊率最高的亚组包括：1）以医疗补助作为主要支付来源的人群（17.3%）；2）5岁及以下儿童（15.2%）；3）无法确定私人医生的人（14.1%）；4）失业人员（13.1%）；5）在正常办公时间就诊的患者（12.6%）；6）未尝试联系私人医生的人（12.4%）。这些不合理使用情况的差异在P值小于0.05或更低水平时均具有统计学意义。无法确定私人医生成为对不合理急诊科就诊率影响最普遍的因素（P值小于0.001）。
