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題名:影響急診病患暫留時間之相關因素探討
書刊名:臺灣公共衛生雜誌
作者:吳秋芬吳肖琪石富元許銘能
作者(外文):Wu, Chiu-fenWu, Shiao-chiShih, Fuh-yuanShiu, Ming-neng
出版日期:2008
卷期:27:6
頁次:頁507-518
主題關鍵詞:急診暫留時間檢傷分類醫療品質EmergencyLength of stayTriageQuality of health care
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(5) 博士論文(1) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:5
  • 共同引用共同引用:11
  • 點閱點閱:130
目標:利用全民健保資料檔檢視我國急診病患之急診暫留情形及急診長時間暫留相關因素探討。方法:採橫斷式研究法,利用2005年衛生署全民健保門住診資料選取該年急診就診個案。利用邏輯斯迴歸分析影響不同急診暫留時間之相關因素探討。結果:2005年急診就醫總人次為6,508,597人次,平均當年度每百人就醫次數為26.43次,急診後留觀率為7.7%,留觀者中留觀超過一日佔13.0%,留觀超過二日佔5.6%。急診留觀情形受病患特質(年齡越大、男性、非假日就醫、緊急程度越高、共病情形嚴重、非重大傷病者)、區域特質(居住地都市化程度越低、在地就醫)、醫院特質(公立醫院、醫學中心、教學醫院、總佔床率高、急診量高或低者)等影響。急診留觀者(暫留大於六小時者)中是否需留觀超過一日或超過二日,皆以假日就醫、重大傷病身份、非緊急程度、跨區就醫、至急診量低的醫院就醫易超長急診留觀。結論:我國急診留觀時間過長情形仍舊存在,應加強輔導改善,以提升急診醫療品質。
Objectives: The National Health Insurance database was used to explore the length of stay (LOS) and related factors in patients utilizing emergency rooms. Methods: In this cross-sectional study, patient use of emergency medical care was analyzed using clinic and hospital claims data from the Bureau of National Health Insurance (BNHI) in 2005. The factors related to emergency department length of stay (EDLOS) were analyzed by logistic regression. Results: There were 6,508,597 persons who had used emergency medical services in 2005, averaging every hundred human of every year 26.43 times. The was 7.7% patients staying at emergency room for observation, 13% and 5.6% of these patients staying at emergency room longer than one and two days for observation, respectively. Patient characteristics associated with EDLOS included old age, male gender, and visiting during a non-holiday. In addition, the presence of urgent medical conditions, comorbidity, or non-serious illness was associated with EDLOS. The regional characteristics associated with EDLOS were as follows: less urbanized area and local visits. Public, medical centers and teaching hospitals with higher occupancy rates and extremely high or low emergency visits were also associated with EDLOS. An observation time of more than one or two days was also influenced by these characteristics including a holiday visit, serious illness, non-urgent illness, visiting at hospital with low emergency department service volume, and cross-boundary visits. Conclusions: The length of stay in emergency rooms still long in Taiwan. Interventions for facilitating emergency medical services are necessary for improving quality.
期刊論文
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2.周歆凱、張怡秋、黃興進、蔡明足、翁林仲、蘇喜(20070900)。運用「購物籃分析技術」探討滯留急診超過24小時病患特性。醫務管理期刊,8(3),216-231。new window  延伸查詢new window
3.Gardner, R. L.、Sarkar, U.、Maselli, J. H.、Gonzales, R.(2007)。Factors Associated with Longer ED Lengths of Stay。American Journal of Emergency Medicine,25(6),643-650。  new window
4.吳肖琪、吳義勇、朱慧凡、林嘉彥、李鐘祥、張錦文、藍忠孚(20020400)。我國醫院醫療品質指標使用之情形。醫療品質,2(2),1-14。new window  延伸查詢new window
5.Bayley, M. D.、Schwartz, J. S.、Shofer, F. S.(2005)。The Financial Burden of Emergency Department Congestion and Hospital Crowding for Chest Pain Patients Awaiting Admission。Annals of Emergency Medicine,45,110-117。  new window
6.Diercks, D. B.、Roe, M. T.、Chen, A. Y.(2007)。Prolonged Emergency Department Stays of Non-ST-segmentelevation Myocardial Infarction Patients are Associated with Worse Adherence to the American College of Cardiology/American Heart Association Guidelines for Management and Increased Adverse Events。Annals of Emergency Medicine,50,489-496。  new window
7.Fromm, R. E., Jr.、Gibbs, L. R.、McCallum, W. G.(1993)。Critical Care in the Emergency Department: A Timebased Study。Critical Care Medicine,21,970-976。  new window
8.Rathlev, N. K.、Chessare, J.、Olshaker, J.(2007)。Time Series Analysis of Variables Associated with Daily Mean Emergency Department Length of Stay。Annals of Emergency Medicine,49,265-271。  new window
9.Shih, F. Y.、Ma, M. H.、Chen, S. C.(1999)。ED Overcrowding in Taiwan: Facts and Strategies。American Journal of Emergency Medicine,17,198-202。  new window
10.楊博文、王立敏、黃彥粹(2003)。臺北市某醫學中心急診部留觀病人分析。臺灣急診醫學會醫誌,5,75-81。  延伸查詢new window
11.Yoon, P.、Steiner, I.、Reinhardt, G.(2003)。Analysis of Factors Influencing Length of Stay in the Emergency Department。Journal of the Canadian Association of Emergency Physicians,5,155-161。  new window
12.何世杰、阮祺文、林月招、許維尹、侯秀慧、周志中(2001)。急診留觀患者超過48小時原因分析。彰化醫學,6,235-245。  延伸查詢new window
13.Travers, D. A.、Haas, S. W.、Waller, A. E.、Tintinalli, J. E.(2003)。Diagnosis Clusters for Emergency Medicine。Academic Emergency Medicine,10,1337-1344。  new window
14.Forster, A. J.、Stiell, I.、Wells, G.、Lee, A. J.、Van, Walraven C.(2003)。The Effect of Hospital Occupancy on Emergency Department Length of Stay and Patient Disposition。Academic Emergency Medicine,10,127-133。  new window
15.Krochmal, P.、Riley, T. A.(1994)。Increased Health Care Costs Associated with ED Overcrowding。American Journal of Emergency Medicine,12,265-266。  new window
16.胡勝川、顏鴻章、高偉峰(2001)。東部某醫學中心急診之人口學籍品質檢討。慈濟醫學,13,223-229。  延伸查詢new window
17.Asaro, P. V.、Lewis, L. M.、Boxerman, S. B.(2007)。The Impact of Input and Output Factors on Emergency Department Throughput。Academic Emergency Medicine,14(3),235-242。  new window
18.Banerjea, K.、Carter, A. O.(2006)。Waiting and Interaction times for Patients in a Developing Country Accident and Emergency Department。Emergency Medicine Journal,23,286-290。  new window
19.Crenshaw, L. A.、Lindsell, C. J.、Storrow, A. B.、Lyons, M. S.(2006)。An Evaluation of Emergency Physician Selection of Observation Unit Patients。American Journal of Emergency Medicine,24,271-279。  new window
20.Langhan, T. S.(2007)。Do Elective Surgical and Medical Admission Simpact Emergency Department Length of Stay Measurements?。Clinical and Investigative Medicine,30,177-182。  new window
21.Clark, K.、Normile, L. B.(2007)。Influence of Time-to-interventions for Emergency Department Critical Care Patients on Hospital Mortality。Journal of Emergency Nursing,33,6-13。  new window
22.Ross, M. A.、Compton, S.、Richardson, D.、Jones, R.、Nittis, T.、Wilson, A.(2003)。The Use and Effectiveness of an Emergency Department Observation Unit for Elderly Patients。Annals of Emergency Medicine,41,668-677。  new window
23.Gorelick, M. H.、Yen, K.、Yun, H. J.(2005)。The Effect of In-room Registration on Emergency Department Length of Stay。Annals of Emergency Medicine,45,128-133。  new window
24.Baumann, M. R.、Strout, T. D.(2007)。Triage of Geriatric Patients in the Emergency Department: Validity and Aurvival with the Emergency Severity Index。Annals of Emergency Medicine,49,234-240。  new window
25.Harris, L.、Bombin, M.、Chi, F.、DeBortoli, T.、Long, J.(1997)。Use of Emergency Departments by the Elderly in Rural Areas。Southern Medical Journal,90,616-620。  new window
26.Liew, D.、Kennedy, M. P.(2003)。Emergency Department Length of Stay Independently Predicts Excess Inpatient Length of Stay。The Medical Journal of Australia,179,524-526。  new window
27.Sprivulis, P. C.、Da, Silva J. A.、Jacobs, I. G.、Frazer, A. R.、Jelinek, G. A.(2006)。The Association between Hospital Overcrowding and Mortality among Patients Admitted via Western Australian Emergency Departments。The Medical Journal of Australia,184,208-212。  new window
28.McCaig, L.、Nawar, E. W.(2006)。Division of Health Care Statistics, National Hospital Ambulatory Medical Care Survey: 2004 Emergency Department Summary。Vital and Health Statistics,372,1-29。  new window
29.Nawar, E. W.、Niska, R. W.、Xu, J.(2007)。National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary。Vital and Health Statistics,386,1-32。  new window
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研究報告
1.沈希哲(2002)。財團法人醫院評鑑暨醫療品質策進會財團法人醫院評鑑暨醫療品質策進會TQIP研究計畫-子計畫七:瞭解並分析停留時間長短對急診醫療品質良窳的影響。臺北。  延伸查詢new window
學位論文
1.李芳年(2000)。急診病人的資源耗用-以臺北市某區域教學醫院為例,0。  延伸查詢new window
2.丁修文。急診醫療結果面品質影響因素之探討-以某區域教學醫院兒科氣喘急診病患為例,0。  延伸查詢new window
3.黃妙鈴(1999)。全民健康保險急診醫療利用之分析研究:兼論其對緊急醫療政策與管理之意涵,0。  延伸查詢new window
4.劉淑琴(1998)。緊急醫療服務之研究-臺中縣市醫學中心與區域醫院急診服務之調查分析,0。  延伸查詢new window
圖書
1.Institute of Medicine Committee on the Future of Emergency Care in the U. S. Health System(2006)。Hospital-based Emergency Care: At the Breaking Point。Hospital-based Emergency Care: At the Breaking Point。Washington, DC。  new window
其他
1.中央健康保險局。醫院總額指標說明,2007,0。  延伸查詢new window
2.臺灣醫務管理學會。THIS指標,2008,0。  延伸查詢new window
 
 
 
 
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