COMPARISON OF ATTENDANCE AND EMERGENCY ADMISSION PATTERNS AT ACCIDENT AND EMERGENCY DEPARTMENTS IN AND OUT OF LONDON
COMPARISON OF ATTENDANCE AND EMERGENCY ADMISSION PATTERNS AT ACCIDENT AND EMERGENCY DEPARTMENTS IN AND OUT OF LONDON
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DOI：
10.1136/bmj.306.6887.1241
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发表时间：
1993-05-08
影响因子：
--
通讯作者：
MANDALIA, S
中科院分区：
文献类型：
--
作者：
JANKOWSKI, RF;MANDALIA, S
目的：比较伦敦市内急诊科和伦敦外城镇急诊科的社会人口学特征、诊断、转诊模式和急诊入院情况。设计标准化的调查问卷由伦敦市内教学医院和伦敦郊外附属教学医院的现场工作人员在两周多的时间内完成。研究对象--3039名新来急诊科就诊的成年人，1476名在伦敦市内和1563名在伦敦以外地区就诊。主要观察指标--社会人口学特征、诊断、转诊模式和患者是否入院。结果--全科医生转诊占成人就诊人数的比例相似(在伦敦市中心，12%)伦敦以外的地区占15%)。在伦敦市中心住宅区参加活动的人更有可能是游客或长途通勤者(12%(179/1476)对6%(95/1563))，单身(43%(643)对32%(505))，独居(24%(360)对14%(225))，最近搬家(13%(194)对7%(107))，或无家可归(3.3%(48)对0.6%(10))。两个科室的患者临床分组大致相似。291人在伦敦市中心获准入境，284人在伦敦以外地区获准入境。在两家医院，每个社会人口学群体的入院比例相似。结论-在确定伦敦内外急诊科就诊人数的差异时，社会人口学特征的差异比一般的转诊模式更重要。这些特征中的许多很可能在其他市中心的人口中也能找到。改善伦敦市中心急诊护理的战略应该考虑到这些社会人口统计学上不同群体的需求。
Objective-To compare the sociodemographic characteristics, diagnoses, and mode of referral of people and emergency admissions between an accident and emergency department in inner London and one in a town outside London.Design-Standardised questionnaire completed prospectively over two weeks by fieldworkers in each accident and emergency department.Setting-Accident and emergency departments in an inner London teaching hospital and an associated teaching hospital outside London.Subjects-3039 adults newly attending the departments, 1476 in inner London and 1563 outside London.Main outcome measures-Sociodemographic characteristics, diagnosis, mode of referral, and whether the patient was admitted.Results-General practitioner referrals accounted for similar proportions of the adult attendances (12% in inner London, 15% outside London). People attending at the inner London department were more likely to be tourists or long distance commuters (12% (179/1476) v 6% (95/1563)), single (43% (643) v 32% (505)), to live alone (24% (360) v 14% (225)), to have moved recently (13% (194) v 7% (107)), or to be homeless (3.3% (48) v 0.6% (10)). Broad clinical groupings of patients were similar in both departments. 291 people were admitted in inner London and 284 outside London. The proportions admitted from each sociodemographic group were similar in the two hospitals.Conclusion-Differences in sociodemographic characteristics were more important than general practice referral patterns in determining the differences in people attending at accident and emergency departments inside and outside London. Many of these characteristics are likely to be found in other inner city populations. A strategy to improve acute care in inner London should take account of the needs of these sociodemographically different groups.