Strang I W, Boddy F A, Jennett B
Br Med J. 1977 Feb 26;1(6060):545-8. doi: 10.1136/bmj.1.6060.545.
A survey was made of all patients in general surgical, urological, and orthopaedic and accident wards in Glasgow on one day in June 1975. Its purpose was to define features of acute surgical practice of relevance to the future planning of resources, particularly bed numbers. Over 40% of the patients in both surgical and orthopaedic wards were over 65 years. Most patients had serious conditions and could not have been treated other than by admission to an acute surgical ward. But a substantial minority no longer needed such facilities and could have been transferred to second-line beds, although many still required skilled nursing care. Delay in the discharge of elderly patients from acute surgical wards as a consequence of non-surgical (often medical or social) problems results in a proportion of acute surgical beds fulfilling a second-line function. Unless arrangements for the earlier discharge of these patients are made any reduction in acute surgical beds is likely to restrict elective surgery, especially in orthopaedics.
1975年6月的一天,对格拉斯哥普通外科、泌尿外科、骨科及急症病房的所有患者进行了一次调查。其目的是确定与未来资源规划(尤其是床位数量)相关的急性外科手术实践特征。外科和骨科病房中超过40%的患者年龄在65岁以上。大多数患者病情严重,若非入住急性外科病房则无法得到治疗。但有相当一部分患者不再需要此类设施,本可转至二线病床,尽管其中许多人仍需要专业护理。由于非手术问题(通常是医疗或社会问题)导致老年患者从急性外科病房延迟出院,使得一部分急性外科病床发挥了二线功能。除非做出让这些患者更早出院的安排,否则急性外科病床数量的任何减少都可能限制择期手术,尤其是骨科手术。