Gifford M J, Franaszek J B, Gibson G
Ann Emerg Med. 1980 Oct;9(10):502-7. doi: 10.1016/s0196-0644(80)80187-9.
A study was conducted under the sponsorship of the Emergency Medical Services (EMS) Committee of the American College of Emergency Physicians (ACEP) that was intended to examine prospectively patients' and physicians' perceptions of the urgency of need for medical attention. Patients presenting to the emergency departments of 24 hospitals between February 25, 1980 and March 3, 1980, were surveyed. The hospitals represented a range of geographic areas and bed capacities. At each hospital a standard data collection questionnaire was supplied to every patient presenting to the emergency department within the study period and a standard form was provided to the physician seeing each patient during the study period. A total of 10,253 forms (87% compliance) were returned and evaluated. Physicians' initial (prospective) assessments indicated that 12.6% of patients needed attention immediately (within minutes); 26.3%, urgently (within 1 to 2 hr); and 28.1%, promptly (within 2 to 12 hr). Retrospectively, reassessment by physicians indicated that 9.4% of patients needed attention immediately; 23.4%, urgently; and 29.6%, promptly. Patients' evaluations of urgency differed significantly (P < 0.05): 44.4% thought they needed care immediately; 28.5%, urgently; and 15.6%, promptly. Physicians concurred that 70% of these patients needed care within 13 hr. Twelve percent of patients rated the urgency of their condition lower than did the physicians, and 25% of patients that the physicians rated as needing immediate attention did not recognize the need for urgent care and thought they could wait from 1 hr to days. This study indicates that patients presenting to the emergency department need care more urgently than was previously supposed.
一项由美国急诊医师学会（ACEP）紧急医疗服务（EMS）委员会赞助的研究，旨在前瞻性地考察患者和医生对医疗救治紧迫性需求的认知。对1980年2月25日至1980年3月3日期间前往24家医院急诊科就诊的患者进行了调查。这些医院代表了不同的地理区域和床位容量。在每家医院，向研究期间到急诊科就诊的每位患者提供一份标准的数据收集问卷，并向在研究期间诊治每位患者的医生提供一份标准表格。共收回并评估了10253份表格（回收率87%）。医生最初（前瞻性）的评估表明，12.6%的患者需要立即（数分钟内）得到救治；26.3%的患者需要紧急（1至2小时内）救治；28.1%的患者需要及时（2至12小时内）救治。回顾性地看，医生重新评估表明，9.4%的患者需要立即得到救治；23.4%的患者需要紧急救治；29.6%的患者需要及时救治。患者对紧迫性的评估存在显著差异（P<0.05）：44.4%的患者认为自己需要立即得到治疗；28.5%的患者认为需要紧急治疗；15.6%的患者认为需要及时治疗。医生一致认为，这些患者中有70%需要在13小时内得到治疗。12%的患者对自身病情紧迫性的评级低于医生的评级，25%被医生评为需要立即治疗的患者并未意识到需要紧急治疗，认为自己可以等待1小时至数天。这项研究表明，前往急诊科就诊的患者比之前认为的更急需治疗。
