CAJ | 학술논문

目的急诊科拥挤现象已成为全球性医疗卫生问题.本项目旨在系统回顾急诊科拥挤现象的研究现况,探讨研究中存在问题和今后研究方向,为解决该问题寻找路径.方法通过PubMed和BMC开放文献检索系统搜索,对1974年至2012年包含“急诊科”和“拥挤”关键词的论著、综述、评论类1587篇相关文献进行分析.结果入选1587篇文献中,论著835篇(52.6％),学科建设论文337篇(21.2％),述评(包括述评、评论、视点等)302篇(19.0％),其他(包括综述和系统性回顾)113篇(7.1％).论著中大部分是单中心观察性研究(n=722,86.5％),仅2.8％为多中心研究.研究文献主要来自美国、加拿大、澳大利亚3个国家(81.0％),但地理分布区域广,多达48个国家和地区报告急诊科拥挤相关论文.且近十年来急诊科拥挤相关研究论文数量急剧增加,2003-2012年间文献占全部文献的79％.从论文主要涉及的内容来看,拥挤度评估方法方面文献最少(5.4％).结论本文系统分析了全球急诊科拥挤相关文献构成情况和内涵质量,资料显示急诊科拥挤研究具有地理分布广、论文数量呈急剧增加特点,但论文的质量仍有待提高.急诊科拥挤度评估方法是当前研究的主要瓶颈之一,建立客观、高效的急诊科拥挤评估方法是今后迫切需要解决的课题.
목적 급진과옹제현상이성위전구성의료위생문제.본항목지재계통회고급진과옹제현상적연구현황,탐토연구중존재문제화금후연구방향,위해결해문제심조로경.방법 통과PubMed화BMC개방문헌검색계통수색,대1974년지2012년포함“급진과”화“옹제”관건사적론저、종술、평론류1587편상관문헌진행분석.결과 입선1587편문헌중,론저835편(52.6％),학과건설논문337편(21.2％),술평(포괄술평、평론、시점등)302편(19.0％),기타(포괄종술화계통성회고)113편(7.1％).론저중대부분시단중심관찰성연구(n=722,86.5％),부2.8％위다중심연구.연구문헌주요래자미국、가나대、오대리아3개국가(81.0％),단지리분포구역엄,다체48개국가화지구보고급진과옹제상관논문.차근십년래급진과옹제상관연구논문수량급극증가,2003-2012년간문헌점전부문헌적79％.종논문주요섭급적내용래간,옹제도평고방법방면문헌최소(5.4％).결론 본문계통분석료전구급진과옹제상관문헌구성정황화내함질량,자료현시급진과옹제연구구유지리분포엄、논문수량정급극증가특점,단논문적질량잉유대제고.급진과옹제도평고방법시당전연구적주요병경지일,건립객관、고효적급진과옹제평고방법시금후박절수요해결적과제.
Objective Emergency department overcrowding (EDO) is an increasingly international occurrence which affects the quality and access of health care across the globe.We assessed perceptions of EDO by a detailed and comprehensive surveying of current international research literatures.Methods Through PubMed and BMC electronic literatures search engines from 1974 to 2012,1587 papers of original articles,reviews and comments with key words " emergency department " AND " crowding" OR "overcrowding" are selected.Results 52.6％ (835/1587) all selected literatures is original research articles.21.2％ (n =337) of these papers involved the disciplinary construction of emergency medicine,and editorial comment (included viewpoints) holds almost one fifth (302,19.0％).Most common types of study methods in all original researches is single-center cohort study (722/835,86.5％),and none of them was multi-center,randomized control clinical trial.The number of papers on EDO is 8 during 1974 and 1988,and gradually elevated to 325 during 1989 and 2002.Yet the number has climbed up to 1254 dramatically (account for 79％) during 2003 and 2012.Together,USA,Canada and Austria,these three countries generated more than three-quarters of all published literatures (81.0％).So far,the authors in 48 countries and areas gave forth initial contributions in the field of EDO.Conclusions The studies and papers about EDO are steadily increasing in recent years.But the investigation shows the research quality still remain need to improve.This systemic review on EDO studies showed that the standardized measurement of EDO has become the bottleneck of EDO study.It is very important and urgent for ED staff to establish an objective and effective EDO evaluation system.