Brokaw J, Olson L, Fullerton L, Tandberg D, Sklar D
University of New Mexico School of Medicine, Department of Emergency Medicine, Albuquerque 87131-5246, USA.
Am J Emerg Med. 1998 Mar;16(2):141-4. doi: 10.1016/s0735-6757(98)90031-6.
Three chronic conditions were examined--acute alcohol intoxication, seizure disorder, and respiratory illness--to quantify the extent of repetitive emergency medical services (EMS) use in a defined population. Urban EMS system ambulance data from 1992 to 1994 were analyzed for the three designated conditions with respect to transports by condition and individual patient. Analysis by chi2 was used for comparing proportions. Analysis of variance after square root transformation was used to evaluate differences among means. The total number of transports analyzed was 15,541: 7,488 for acute alcohol intoxication, 4,670 for respiratory illness, and 3,383 for seizure disorder. These transports involved 8,692 patients who were transported at least once for one of the three designated conditions. The mean number of transports for alcohol was 1.96 (95% confidence intervals [CI]: 1.92, 2.01), seizure 1.32 (95% CI: 1.27, 1.36), and respiratory 1.18 (95% CI: 1.15, 1.21). Of 369 patients transported five or more times during the study period, 260 (70.5%) were for alcohol, 56 (15.2%) for seizure, and 53 (14.4%) for respiratory complaints. This group comprised only 4.3% of patients, but 28.4% of all transports. Acute alcohol intoxication resulted in more repetitive ambulance transports than either seizure disorder or respiratory illness. A small number of patients were responsible for a large number of transports. Focused intervention for patients with high ambulance transport deserves further study.
研究了三种慢性病——急性酒精中毒、癫痫障碍和呼吸系统疾病——以量化特定人群中重复使用紧急医疗服务（EMS）的程度。分析了1992年至1994年城市EMS系统救护车数据中这三种指定疾病按疾病类型和个体患者的运输情况。使用卡方分析比较比例。对平方根变换后的方差进行分析以评估均值之间的差异。分析的运输总数为15541次：急性酒精中毒7488次，呼吸系统疾病4670次，癫痫障碍3383次。这些运输涉及8692名患者，他们因三种指定疾病之一至少被运输过一次。酒精中毒的平均运输次数为1.96（95%置信区间[CI]：1.92，2.01），癫痫为1.32（95%CI：1.27，1.36），呼吸系统疾病为1.18（95%CI：1.15，1.21）。在研究期间被运输五次或更多次的369名患者中，260名（70.5%）是因酒精中毒，56名（15.2%）是因癫痫，53名（14.4%）是因呼吸系统疾病。该组患者仅占所有患者的4.3%，但占所有运输次数的28.4%。急性酒精中毒导致的重复救护车运输比癫痫障碍或呼吸系统疾病更多。少数患者导致了大量的运输。对高救护车运输次数患者的针对性干预值得进一步研究。
