Burnett M G, Grover S A
Centre for the Analysis of Cost-Effective Care, Montreal General Hospital, Que.
CMAJ. 1996 May 1;154(9):1345-51.
To characterize the patient population seeking care for nonurgent medical problems at an emergency department during regular business hours and to determine why these patients chose the emergency department over alternative care sites.
Patient survey (self-administered questionnaire).
Emergency department at a tertiary care hospital in Montreal.
All ambulatory patients presenting on weekdays between 8 am and 5 pm from Nov. 10 to Dec. 8, 1993, whose condition was determined to be nonurgent. Eligible patients had to be residents of Montreal, who did not have a pre-arranged consultation at the emergency department. Of 202 consecutive eligible patients, 200 agreed to participate.
Description of events leading to the visit, including possible attempts by patients to contact their regular physician; patients' knowledge of alternative care options such as provincial CLSGs (centres locaux des services communautaires) and private walk-in clinics.
Of the 200 patients 152 (76%) stated that they had not visited an emergency department within the previous month, and only 10 (5%) stated that they were in extreme pain. At least 70% were aware of alternative care options, however, 120 (60%) felt that the emergency department was the best place for them to receive care for their medical problem. In all, 81 patients (40%) were referred to the emergency department; 62 (77%) were referred by a health care professional, 46 (57%) by a physician.
Most patients are aware of alternatives to the emergency department for care of nonurgent medical problems. Nevertheless, a large number are being referred to the emergency department during regular business hours by health care professionals. This inefficient use of expensive hospital resources requires further investigation.
描述在正常工作时间前往急诊科寻求非紧急医疗问题治疗的患者群体特征，并确定这些患者选择急诊科而非其他医疗机构的原因。
患者调查（自行填写问卷）。
蒙特利尔一家三级护理医院的急诊科。
1993年11月10日至12月8日期间工作日上午8点至下午5点前来就诊的所有非紧急病情的门诊患者。符合条件的患者必须是蒙特利尔居民，且未在急诊科提前预约会诊。在连续202名符合条件的患者中，200名同意参与。
描述导致就诊的事件，包括患者联系其常规医生的可能尝试；患者对其他医疗选择的了解，如省级社区服务中心（CLSGs）和私人即时诊所。
200名患者中，152名（76%）表示前一个月内未去过急诊科，只有10名（5%）表示处于极度疼痛中。至少70%的患者知晓其他医疗选择，然而，120名（60%）认为急诊科是他们接受医疗问题治疗的最佳场所。总共有81名患者（40%）被转诊至急诊科；62名（77%）由医疗保健专业人员转诊，46名（57%）由医生转诊。
大多数患者知晓在非紧急医疗问题时可选择急诊科以外的医疗机构。尽管如此，仍有大量患者在正常工作时间被医疗保健专业人员转诊至急诊科。这种对昂贵医院资源的低效利用需要进一步调查。
