Nelson D A, Nelson M A, Shank J C, Thompson F L
J Fam Pract. 1979 Feb;8(2):341-5.
Four hundred individual Emergency Room records were retrospectively reviewed. Demographic data, complaint, diagnosis, and treatment were tabulated and analyzed by computer assistance. Judgment was not made regarding the necessity of physician consultation, but whether an Emergency Room visit was warranted considering the duration of the presenting complaint. During a time period when 29 percent of the total outpatient visits to the Family Practice Center Model Office were made by recipients of Medical Assistance, the same population accounted for 53 percent of the Emergency Room visits reviewed. Twenty-five percent of the 400 visits were judged to be unnecessary according to the pre-established criteria. Sixty-four percent of the unnecessary visits were by Medical Assistance patients. Of 304 total families represented, 73 were responsible for multiple visits. Thirty-one percent of these visits were unnecessary, whereas 21 percent of the visits made by families with single visits were unnecessary. In this family practice setting, it is concluded that Medical Assistance patients have a greater tendency toward inappropriate use of the Emergency Room when compared to non-Assistance patients.
对400份急诊室记录进行了回顾性审查。通过计算机辅助将人口统计学数据、主诉、诊断和治疗情况制成表格并进行分析。未对医生会诊的必要性做出判断，而是根据主诉持续时间判断是否有必要去急诊室就诊。在家庭医疗中心模式办公室门诊总量中，有29%是医疗救助受助人就诊期间，同一人群在审查的急诊室就诊中占53%。根据预先设定的标准，400次就诊中有25%被判定为不必要。64%的不必要就诊是医疗救助患者。在总共代表的304个家庭中，73个家庭有多次就诊。这些就诊中有31%是不必要的，而单次就诊家庭的就诊中有21%是不必要的。在这种家庭医疗环境中，得出的结论是，与非救助患者相比，医疗救助患者更倾向于不恰当地使用急诊室。
