Laffoy M, O'Herlihy B, Keye G
Eastern Health Board, Dr. Steevens Hospital, Dublin.
Ir J Med Sci. 1997 Jan-Mar;166(1):35-7. doi: 10.1007/BF02939775.
All new patients attending a Dublin Hospital's Accident and Emergency (A&E) Department were surveyed to document their reasons for attending and to make comparisons between self-referred and GP referred groups. Of the 557 responders 395 (70.9%) were self-referred. Four-fifths of this group said they had a GP but only 6.6 per cent attempted to contact the GP before attending. Compared with GP referred patients the self-referred group were more likely to be under 45 (74.6 per cent v 59.8 per cent, P < 0.01) and have soft tissue injuries (57 per cent v 32.9 per cent, P < 0.01). They were less likely to require laboratory investigation or to be admitted to hospital (11 per cent v 31.2 per cent, P < 0.01). It is likely many of the self-referred patients could have been managed by a GP. However, A & E departments remain popular sources of treatment for patients with a wide variety of conditions. Current methods of delivering health care to patients with minor conditions require assessment so that patient demands for both a responsive minor injury and emergency service can be met. Almost 70 per cent of all hospital admissions originated from the A&E department. This makes rational planning and management of booked admissions difficult. GPs who refer patients for admission should have an alternative route to hospital beds besides the A&E department.
对都柏林一家医院急诊部的所有新患者进行了调查，以记录他们前来就诊的原因，并对自行前来就诊的患者群体和由全科医生转诊的患者群体进行比较。在557名受访者中，395人（70.9%）是自行前来就诊的。该群体中有五分之四的人表示他们有全科医生，但只有6.6%的人在就诊前试图联系全科医生。与全科医生转诊的患者相比，自行前来就诊的患者更有可能年龄在45岁以下（74.6%对59.8%，P<0.01）且有软组织损伤（57%对32.9%，P<0.01）。他们需要实验室检查或住院的可能性较小（11%对31.2%，P<0.01）。很可能许多自行前来就诊的患者本可以由全科医生进行处理。然而，急诊部仍然是各种病症患者受欢迎的治疗来源。当前为轻症患者提供医疗服务的方式需要进行评估，以便满足患者对快速的轻伤和急救服务的需求。几乎所有住院患者中有70%来自急诊部。这使得对预约住院患者进行合理规划和管理变得困难。转诊患者住院的全科医生除了通过急诊部外，应该有其他途径获得医院床位。
