Lombrail P, Alfaro C, Vitoux-Brot C, Brodin M, Bourrillon A, Beaufils F
Service de Santé Publique et Comité des Urgences, Hôpital Robert-Debré, Paris.
Arch Fr Pediatr. 1993 Apr;50(4):313-7.
The increasing demand on the emergency wards of pediatric hospitals raise the question of whether the services delivered are adequate for the explicit and implicit needs of outpatients.
The files of all the 334 children consulting at the medical emergency ward of Robert-Debré hospital in Paris between April 19 and April 26, 1989 were analyzed. Socio-demographic data, reasons for visit and final diagnosis were collected. Each outpatient was assigned to one of 3 categories: 1) severe emergency; 2) simple emergency; 3) consultation. Further data on the events leading to the visit were obtained by a second survey covering 213 children seen between May 11 and May 14, 1991 from 8 hrs to 20 hrs.
The mean age of the 334 children in the first survey was 3.2 years. Half of the mothers were unemployed. Half of the families was of foreign extraction. 3.4% of the children had no social insurance. Ten percent of the patients were frequent users of the emergency ward. Infectious diseases were the most prevalent reason for visit. Severe emergencies were 28%, simple emergencies 44% and consultations 28%. Among the 213 children of the second survey, half of the families had seen (43%) or attempted to see (7%) a physician outside the hospital before coming to the emergency ward.
The needs of the children could best be met by performing a true medico-social examination at the medical emergency ward, enhancing access for children and revitalizing a partnership with the community to provide continuous care for those children in need of it.
儿科医院急诊病房的需求不断增加，引发了所提供服务是否足以满足门诊患者明确和隐含需求的问题。
对1989年4月19日至4月26日期间在巴黎罗伯特 - 德布雷医院医疗急诊病房就诊的334名儿童的病历进行了分析。收集了社会人口统计学数据、就诊原因和最终诊断结果。每位门诊患者被分为以下三类之一：1）严重急诊；2）一般急诊；3）咨询。通过第二次调查获取了导致就诊事件的进一步数据，该调查涵盖了1991年5月11日至5月14日8点至20点期间就诊的213名儿童。
第一次调查的334名儿童的平均年龄为3.2岁。一半的母亲没有工作。一半的家庭有外国血统。3.4%的儿童没有社会保险。10%的患者是急诊病房的常客。传染病是最常见的就诊原因。严重急诊占28%，一般急诊占44%，咨询占28%。在第二次调查的213名儿童中，一半的家庭在前往急诊病房之前曾在医院外看过医生（43%）或试图看过医生（7%）。
通过在医疗急诊病房进行真正的医学 - 社会检查、改善儿童就诊机会以及重振与社区的伙伴关系，为有需要的儿童提供持续护理，可以最好地满足儿童的需求。
