Cortazzo J M, Guertler A T, Rice M M
Department of Emergency Medicine, St Francis Community Hospital, Federal Way, WA.
Am J Emerg Med. 1993 Sep;11(5):456-9. doi: 10.1016/0735-6757(93)90082-m.
The objective of this study was to describe consultation and referral patterns from a military emergency department (ED). The design of the study consisted of a prospective analysis of consultations and referrals from Madigan Army Medical Center ED during April 1990, an Army Medical Center with multiple residencies, including emergency medicine (EM). Patient population included active and retired military personnel, their families, and civilian emergency medical system-transported patients. ED visits averaged 60,000 per year. The overall rate of consultation and referral was 39.9%; 10.7% were consultations, whereas 29.2% were referrals. PGY-2 and -3 EM residents consultation rates were higher than average. Of all ED visits, 19.7% resulted in consultations or referrals to surgical services, 13.6% to medical services, and 2.8% to pediatrics. ED patients frequently are referred to or result in consultations with non-EM physicians. Differences in consultation by level of training and the impact of consultation on consulting services both deserve further investigation. Review of EM resident use of consultation and referral may focus evaluation of ED care in teaching hospitals.
本研究的目的是描述军队急诊科的会诊和转诊模式。该研究的设计包括对1990年4月马迪根陆军医疗中心急诊科的会诊和转诊进行前瞻性分析，该陆军医疗中心有多个住院医师培训项目，包括急诊医学（EM）。患者群体包括现役和退休军人及其家属，以及由民用紧急医疗系统运送的患者。急诊科每年的就诊人数平均为6万。会诊和转诊的总体发生率为39.9%；其中会诊占10.7%，转诊占29.2%。PGY-2和PGY-3级急诊医学住院医师的会诊率高于平均水平。在所有急诊科就诊病例中，19.7%的病例导致了外科服务的会诊或转诊，13.6%的病例导致了内科服务的会诊或转诊，2.8%的病例导致了儿科服务的会诊或转诊。急诊科患者经常被转诊或导致与非急诊医学医生的会诊。培训水平在会诊方面的差异以及会诊对会诊服务的影响都值得进一步研究。对急诊医学住院医师会诊和转诊使用情况的审查可能会聚焦于教学医院急诊科护理的评估。
