Rubin M A, Bonnin M J
Department of Emergency Medicine, University of Texas Medical School at Houston, USA.
J Emerg Med. 1995 Nov-Dec;13(6):839-42. doi: 10.1016/0736-4679(95)02013-6.
Emergency departments (ED) are frequently utilized by patients with minor complaints. It has been a long-standing assumption in the medical community that this use was based on the inability of certain subgroups of the population to access primary care providers secondary to inability to pay. This study examines the use of the ED for minor complaints and the distribution of patients according to mode of payment. Our findings suggest that ED utilization for minor complaints is not, as previously believed, higher in patients with the inability to pay primary care providers. Rather, subsidized patients (Medicare/Medicaid) appear to use the ED equally for major and minor complaints, while there is an increased utilization by commercially insured patients for minor illnesses and injuries, and a lower rate in patients who are self-pay.
急诊科（ED）经常被有轻微不适的患者使用。医学界长期以来一直认为，这种使用是由于某些人群因无力支付而无法获得初级保健提供者的服务。本研究调查了急诊科对轻微不适的使用情况以及患者按支付方式的分布。我们的研究结果表明，无力支付初级保健服务费用的患者对急诊科的轻微不适就诊率并不像之前认为的那样高。相反，受补贴患者（医疗保险/医疗补助）在严重和轻微不适方面似乎同样会使用急诊科，而商业保险患者对轻微疾病和损伤的就诊率有所增加，自费患者的就诊率较低。
