目的：某區域醫院自2000來歷經重大水患與轉型爲「SARS專責醫院」等，不但造成營運困難與中斷，急診服務量亦呈現逐浙下降情形。本研究欲初步了解，除了SARS事件外，什麼樣的事件較易造成急診營運影響，以協助管理者分析原因並利於決策訂定。 方法：將某區域醫院自1999到2005六年間的各項急診醫療服務量的相關變項資料，以事件發生點當月除外的前後相關變項的醫療服務數據量變化，來進行統計分析比較。 結果：以某區域醫院爲例，天災事件並未對急診醫療服務量造成影響。進一步分析後，以醫療環境競爭者增加對與軍人納入健保對急診外科（540±74 vs 445±73, 524±63 vs 409±43, p＜0.05)與急重症等（檢傷第一與二類及第二到第四類）服務量影響較大（p＜0.05），而政策介入與健保給付制度改變對急診內科與相對輕症（檢傷第三與四及二與三類）服務量影響較大（p＜0.05）。軍人的急診就醫人數爲急診醫療服務量變化的主要決定成份因素（p＜0.01）。SARS與調整民眾部分負擔事件確實皆造成急診醫療服務量的重大影響。但不管重大事件爲何，榮民的急診就醫服務量的變化最小。 結論：初步結果顯示納莉水災前後對急診服務量並未造成重大顯著性影響。但鄰近新的醫學中心成立、軍人納入健保、轉型「SARS專責醫院」與健保提高部分負擔金額的前後，相關醫療服務量等變項檢定前後有部分明顯統計差異。

Objectives: In the face of major flooding and hospital changes in becoming a SARS exclusive hospital after 2000, the hospital encountered difficulties in operation. Emergency service volume was also showing a trend of decline. Outside the SARS incident, the purpose of this study is to better understand what types of incidents are prone to influence the operation of emergency services, to provide administrators with a reference for analysis and decision making. Methods: Statistical analysis and comparison of the volume of various kinds of medical services based on pre and post variation of relevant variables of medical service volume (except for the month that incidents occurred) for the period between 1999 and 2005. Results: Taking the hospital as an example, natural disasters do not greatly impact emergency medical service volume (p>0.05). After further analysis, the increase of competitors in medical environment and the inclusion of soldiers in health insurance have a more significant impact on the service volume of surgical ER and emergency as well as critical cases (540±74 vs 445±73, 524±63 vs 409±43, p<0.05). Policy intervention and the change in health insurance payment system had a greater influence on medical ER and lighter medical cases (p<0.05). The number of soldiers who seek emergency treatments in the major decisive factor in emergency medical service volume (p<0.01). The SARS incident and adjustment of patient co-payment indeed was a major impact on emergency medical service volume. Nevertheless, amid major incidents, veteran emergency treatment volume showed the smallest change. Conclusions: Preliminary results show no significant impact before and after NARI typhoon. However, after the establishment of nearby new medical centers, the inclusion of soldiers in the Health Insurance, hospital transformation to become a SARS exclusive hospital, and the increase of health insurance co-payment, some of variables relating to medical service volume showed significant statistical variance.