Grad R, Kaczorowski J, Singer Y, Levitt C, Mandelcorn J
Department of Family Medicine, SMBD Jewish General Hospital, Montreal.
Can Fam Physician. 1998 Dec;44:2666-72.
To determine the annual incidence of patient-defined emergencies and patients' use of emergency services at a family medicine teaching unit.
Cross-sectional survey.
Hospital-based family medicine teaching unit in Montreal.
Registered patients attending a family medicine teaching unit during 11 consecutive weekdays.
Annual incidence of patient-defined medical emergencies and use of emergency services at the unit.
Eligible patients made 815 visits during the study period; 584 usable questionnaires were returned for a response rate of 71.7%. In the previous 12 months, 37% of patients reported at least one medical emergency. For their last emergency, 42% reported using at least one of the emergency services offered by the clinic. Only 19% of patients with after-hours emergencies reported using our on-call system. Although socioeconomic and clinical variables did not predict the incidence of patient-defined emergencies, multivariate analysis revealed three significant predictors for use: patients with the practice for 5 or more years were more likely to use our services, while patients 75 and older and those with emergencies after hours were less likely to use our services.
In an urban group family practice, annual incidence of medical emergencies among registered patients was 37%. Those whose most recent emergency occurred after hours used the clinics' emergency on-call services disappointingly little.
确定在一家家庭医学教学单位中患者定义的紧急情况的年发病率以及患者对急诊服务的使用情况。
横断面调查。
蒙特利尔的一家以医院为基础的家庭医学教学单位。
连续11个工作日内在该家庭医学教学单位就诊的注册患者。
该单位患者定义的医疗紧急情况的年发病率以及急诊服务的使用情况。
在研究期间，符合条件的患者进行了815次就诊；共收回584份可用问卷，回复率为71.7%。在过去12个月中，37%的患者报告至少发生过一次医疗紧急情况。对于他们最近一次的紧急情况，42%的患者报告使用了诊所提供的至少一项急诊服务。在非工作时间发生紧急情况的患者中，只有19%的人报告使用了我们的随叫随到系统。尽管社会经济和临床变量无法预测患者定义的紧急情况的发病率，但多变量分析揭示了三个使用急诊服务的显著预测因素：在该诊所执业5年或更长时间的患者更有可能使用我们的服务，而75岁及以上的患者以及在非工作时间发生紧急情况的患者使用我们服务的可能性较小。
在城市团体家庭医疗实践中，注册患者中医疗紧急情况的年发病率为37%。那些最近一次紧急情况发生在非工作时间的患者对诊所的急诊随叫随到服务的使用率低得令人失望。
