目的 分析华北地区某医院院前急救医疗服务的资源利用状况,并依据相关影响因素针对院前急救医疗服务过程中存在问题提出相应对策。方法 收集2021年3月—2022年4月期间就诊于华北地区某医院急诊科患者的一般资料、就诊过程、症状特征。依据是否接受过院前急救服务、是否为疾病急性发作的危重症患者将患者分为4组,分析比较4组患者在一般资料、疾病病症特点两个方面是否存在统计学差异,探索影响院前急救医疗资源合理利用的相关因素。结果 本研究总计收纳患者病例5 800例,其中接受院前急救医疗服务的患者共840例占总调查人数的14.5%,其中危重症患者530例（63.1%）,非危重症患者310例（36.9%）;未接受院前急救医疗服务的患者为4 960例占总调查人数的85.5%,其中危重症患者803例（16.2%）。对所得数据采用多因素回归方法分析得知,在急诊科接受的危重症患者中急性胸痛与突发性头痛是选择不使用院前急救医疗措施的独立影响因素。在非危重症患者中发热、外伤、腹痛是非急重症患者接受院前急救医疗服务的独立影响因素。结论 院前急救医疗服务资源的提供与利用在实际应用的过程中存在资源闲置与服务空缺的问题。危重症患者在入院前仍有较大比例的患者没有选择接受院前急救医疗服务。该情况表明当前居民对危重症患者危重症状及院前急救医疗服务了解与认知不足,对此有必要加强对居民关于院前急救服务的科普宣教工作,并借助现有医疗服务力量支持院前急救医疗服务的规范与准则,这对保障患者生命安全,争取危重症患者存活机会,促进急救资源合理利用具有重要意义。

Objective To analyze the resource utilization status of pre-hospital emergency medical services in a hospital in North China,and to propose corresponding countermeasures for problems in the process of pre-hospital emergency medical services according to relevant influencing factors．Methods From March 2021 to April 2022,the general data,treatment process and symptom characteristics of patients who were treated in the emergency department of a hospital in North China were collected．According to whether they had received pre-hospital emergency services and whether they were critically ill patients with acute onset of disease,the patients were divided into four groups．Whether there were statistical differences in the general data and disease characteristics of the four groups of patients,and the relevant factors affecting the rational utilization of pre-hospital emergency medical resources were explored．Results This study included 5 800 patients,of which 840 patients receiving pre-hospital emergency medical services,accounted for 14.5% of the total survey,including 530（63.1%）and 310 non-critically ill patients（36.9%）;4 960 patients not receiving pre-hospital emergency medical services accounted for 85.5% of the total survey,including 803（16.2%）of critically ill patients．Analysis by multivariate regression methods on the obtained data showed that acute chest pain and sudden headache in critically ill patients in the emergency department were independent influencing factors in choosing not to use pre-hospital emergency medical measures．Fever,trauma,and abdominal pain in non-critically ill patients were independent factors influencing the reception of pre-hospital emergency medical services．Conclusions The provision and utilization of pre-hospital emergency medical service resources have the problem of idle resources and service vacancies in the process of practical application．A significant proportion of critically ill patients still do not choose to receive pre-hospital emergency medical services before admission．This situation shows that the current residents have insufficient understanding and cognition of critical symptoms and pre-hospital emergency medical services,and it is necessary to strengthen the scientific popularization and education of residents on pre-hospital emergency services,and support the norms and guidelines of pre-hospital emergency medical services with the help of existed medical services,which is of great significance for ensuring the safety of patients' lives,striving for the survival opportunities of critically ill patients,and promoting the rational use of emergency resources．

目的 “看病难”这个与社会民生密切相关的难题,长期困扰广大民众。主要表现在看病流程复杂,挂号、候诊排队时间长,就诊指引不清晰,服务水平低。移动互联网时代,各个传统行业都在转变运营模式,医院应如何因势利导,寻求“破冰”良策。本文结合佛山市中医院的应用案例,对利用微信公众号^[1]改造现有业务流程,有效解决“看病难”问题进行讨论分析。

The problem “proper health care is difficult to get” is closely related to the people's livelihood,which has plagued the people for a long period of time.The difficulties mainly focused on the complex process,long-time waiting,unclear instruction and the low level of service.In the time of mobile internet,each traditional industry is shifting the operation mode.What the hospital should do to is to make the best use of the advantages to solve the problems.The purpose of the research is to optimize the current processes and to solve the problem of “Proper health care is difficult to get” by using Wechat public number combined with the cases in Foshan hospital of traditional Chinese medicine.