Gavaler J S, Van Thiel D H
J Natl Med Assoc. 1980 Jan;72(1):33-5.
During designated sampling periods, all patients presenting at an urban hospital Emergency Room with complaints meeting nonurgent criteria were interviewed in an effort to examine patterns of Emergency Room usage and to characterize those patients utilizing the Emergency Room inappropriately. Each such patient's stated number of visits to an Emergency Room during the previous year, including the present visit, was used as an indicator in assessing inappropriate Emergency Room use. Statistical analysis showed no significant differences when the variable was race; in contrast, significant differences were seen when the variables were type of medical insurance coverage and personal physician status. Based on these data, we suggest that the true problem is not one of how to control inappropriate Emergency Room use, but rather one of how to improve the health care delivery system for the urban poor.
在指定的采样期间，对所有前往城市医院急诊室就诊且主诉符合非紧急标准的患者进行了访谈，以研究急诊室的使用模式，并对那些不恰当地使用急诊室的患者进行特征描述。每位此类患者陈述的包括本次就诊在内的上一年急诊室就诊次数，被用作评估急诊室不恰当使用情况的一项指标。统计分析表明，当变量为种族时，未发现显著差异；相比之下，当变量为医疗保险类型和私人医生状况时，则出现了显著差异。基于这些数据，我们认为真正的问题不是如何控制急诊室的不恰当使用，而是如何改善城市贫困人口的医疗保健服务体系。
