Care in the emergency department: How crowded is overcrowded?
Care in the emergency department: How crowded is overcrowded?
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DOI：
10.1197/j.aem.2004.07.004
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发表时间：
2004-10-01
影响因子：
4.4
通讯作者：
Concato, J
中科院分区：
文献类型：
--
作者：
Hwang, U;Concato, J
目的：研究医学文献中如何定义急诊科（艾德）过度拥挤。方法：使用美国国家医学图书馆的PubMed和MEDLINE数据库（1966年至2002年），对英语医学文献进行全面回顾，以确定定义的明确标准艾德过度拥挤。纳入标准为原创文章、社论和评论;排除新闻文章和给编辑的信件。使用标准化的摘录表格，如果标题或导言或方法段落中的客观陈述提到拥挤或过度拥挤，则将出版物描述为主要出版物;所有其他引文均归类为次要引文。然后对每份报告进行评估，以确定拥挤或过度拥挤是否明确或含蓄地定义。明确的定义包括短语，如“拥挤被定义为......“或“过度拥挤发生在...... ";结果：共检索到231篇候选文献，91篇符合纳入标准，53篇（58%）为关于艾德拥挤或过度拥挤的主要文献。在这些主要文章中，23篇（43%）对拥挤或过度拥挤有明确的定义。的定义在内容和重点，包括艾德，医院，或外部（非医院）factors.Conclusions：虽然艾德拥挤一直是一个经常调查的主题，目前的定义的问题往往是隐含的或专注于艾德本身以外的因素。一个更一致的方法来定义艾德过度拥挤将有助于澄清过度拥挤的原因，特征和结果之间的区别。
Objectives: To examine how emergency department (ED) overcrowding has been defined in the medical literature.Methods: Using the National Library of Medicine's PubMed and MEDLINE databases (1966 to 2002), a comprehensive review of the English-language medical literature was conducted to identify explicit criteria for defining ED overcrowding. Inclusion criteria were original articles, editorials, and reviews; news articles and letters to the editor were excluded. Using a standardized extraction form, publications were described as primary if the title or an objective statement in the introductory or methods paragraph referred to crowding or overcrowding; all other citations were categorized as secondary. Each report was then evaluated to determine whether crowding or over-crowding, was defined explicitly or implicitly. Explicit definitions included phrases such as "Crowding was defined as... " or "Overcrowding occurred when... "; other definitions were characterized as implicit.Results: A total of 231 candidate articles were identified; 91 met inclusion criteria, and 53 (58%) were primary articles about ED crowding or overcrowding. Among these primary articles, 23 (43%) had explicit definitions of crowding or overcrowding. The definitions varied widely in content and focus, including ED, hospital, or external (nonhospital) factors.Conclusions: Although ED overcrowding has been a topic of frequent investigation, current definitions of the problem are often implicit or focus on factors outside of the ED itself. A more consistent approach to defining ED overcrowding would help to clarify the distinctions between causes, characteristics, and outcomes of overcrowding.