Kne T, Young R, Spillane L
Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, NY 19042, USA.
Am J Emerg Med. 1998 Nov;16(7):648-52. doi: 10.1016/s0735-6757(98)90166-8.
The objective of this study was to examine the pattern of emergency department (ED) use by frequent ED users over time. This study was a retrospective study of adults with more than 10 visits to a university hospital ED from 8/90 through 7/91. ED visits of this cohort to all hospitals in the metropolitan area were followed for 3 years. Records were reviewed for the etiology of each patient's ED visits. This cohort was comprised of 76 patients making 1,119 (1.9%) of the total 59,051 ED visits. Thirty-five of the 76 (46%) were frequent ED users in only the initial year. Thirteen of the 76 (17%) made more than 10 visits in all 4 years. The remainder had sporadic episodes of ED use. Thirty-five (46%) were evaluated at three or more EDs in years in which they were frequent users. Forty-two (55%) had a medical problem for the cause of the majority of their ED visits. Fifty-eight percent of patients making more than 10 visits in more than 1 year had psychiatric or substance abuse problems. The pattern of ED use in this cohort changed over time and was influenced by substance abuse and psychiatric problems. These data suggest that most patients do not remain frequent ED users over time.
本研究的目的是调查频繁光顾急诊科（ED）的患者随时间推移使用急诊科的模式。本研究是一项回顾性研究，研究对象为1990年8月至1991年7月期间到某大学医院急诊科就诊超过10次的成年人。对该队列患者在大都市地区所有医院的急诊科就诊情况进行了3年的跟踪。查阅了每位患者急诊科就诊的病因记录。该队列由76名患者组成，他们的1119次就诊（占总就诊次数59051次的1.9%）。76名患者中有35名（46%）仅在第一年是频繁光顾急诊科的患者。76名患者中有13名（17%）在全部4年中就诊次数超过10次。其余患者有偶尔光顾急诊科的情况。35名（46%）频繁光顾急诊科的患者在这些年份里在三个或更多的急诊科接受过评估。42名（55%）患者大部分急诊科就诊的原因是患有某种医疗问题。在一年以上时间里就诊次数超过10次的患者中，58%有精神疾病或药物滥用问题。该队列患者使用急诊科的模式随时间发生了变化，且受到药物滥用和精神疾病问题的影响。这些数据表明，随着时间的推移，大多数患者不会一直频繁光顾急诊科。
