三级医院非急诊就诊现象产生的伦理问题探讨

Ethical Issues of Non-emergency Treated in Emergency Department of Top-level Hospital

目的探讨三级医院急诊内科由于非急诊就诊患者就诊所产生的伦理问题。方法运用分层随机抽样的方法,在2010年1～12月,每月随机抽取一周,收集华山医院急诊内科就诊患者,判断并记录该患者是否是可以先在社区卫生服务中心就诊的非急诊就诊患者。结果在所有病例记录中,有39.5%的患者可以先在社区卫生服务中心就诊,属于非急诊就诊患者。真正的急诊患者等待就医、检验及治疗时间延长,医生对其的关注比例降低、交流时间减少,影响其的最优化治疗。结论应提高社区卫生服务中心综合实力,倡导非急诊就诊患者优先至社区卫生服务中心就诊;重视急诊工作,加强急诊人员配备;严格执行急诊准入标准。

Objective：To investigate the ethical issues induced by non -emergency was treated in Internal Emergeny Department of top - level hospitals. Methods ： Using stratified random sampling method, from Jan to Dec of 2010, randomly a week in every month, collected patients imformation in Internal Emergeny Department of Hua- shan hospital, judging that wether the non - emergency patients could be treated preferentially in the community health service center. Results：39.5% of the patients could be treated in community health service center, be- longed to non -emergency patients. Conclusion： Improving the community health service center integrated strength, advocating the non - emergency patients preferentially treated in the community health service center, paying attention to the emergency work, strengthening the emergency medical personnel,strictly carrying out emer- gency access standards are advised.