Where Americans Get Acute Care: Increasingly, It's Not At Their Doctor's Office
Where Americans Get Acute Care: Increasingly, It's Not At Their Doctor's Office
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DOI：
10.1377/hlthaff.2009.1026
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发表时间：
2010-09-01
期刊：
影响因子：
9.7
通讯作者：
Kellermann, Arthur L.
中科院分区：
文献类型：
--
作者：
Pitts, Stephen R.;Carrier, Emily R.;Kellermann, Arthur L.
从历史上看，全科医生在美国提供第一次接触护理。然而，今天，在每年3.54亿次新出现的健康问题的紧急护理治疗中，只有42%是由病人的私人医生进行的。其余的是急诊科（28%）、专科医生（20%）或门诊部（7%）。虽然只有不到5%的医生是急诊医生，但他们处理了四分之一的急诊病例，以及一半以上的未投保者的急诊病例。《患者保护和平价医疗法》中的卫生改革条款旨在促进以患者为中心的医疗之家和负责任的医疗组织，以改善获得急性护理的机会。改革的挑战将是在当前复杂的急性护理环境中取得成功。
Historically, general practitioners provided first-contact care in the United States. Today, however, only 42 percent of the 354 million annual visits for acute care-treatment for newly arising health problems are made to patients' personal physicians. The rest are made to emergency departments (28 percent), specialists (20 percent), or outpatient departments (7 percent). Although fewer than 5 percent of doctors are emergency physicians, they handle a quarter of all acute care encounters and more than half of such visits by the uninsured. Health reform provisions in the Patient Protection and Affordable Care Act that advance patient-centered medical homes and accountable care organizations are intended to improve access to acute care. The challenge for reform will be to succeed in the current, complex acute care landscape.