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題名:臺灣5歲以下嬰幼兒事故傷害住院之醫療利用
書刊名:醫務管理期刊
作者:黃耀緯鍾其祥朱基銘簡戊鑑
作者(外文):Huang, Yao-weiChung, Chi-hsiangChu, Chi-mingChien, Wu-chien
出版日期:2010
卷期:11:3
頁次:頁1-18
主題關鍵詞:傷害兒童住院醫療利用全民健保InjuryChildHospitalizationMedical care utilization
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(4) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:4
  • 共同引用共同引用:67
  • 點閱點閱:94
目的:探討5歲以下兒童事故傷害住院之各項特性,包含病患、環境及傷害特質與醫療利用型態之關係。 方法:本研究以2007年健保「住院醫療費用清單明細檔(DD)」,擷取診斷欄位「外因分類一」及「外因分類二」為E800~E999者進行分析。分別探討病患、環境及傷害特質與手術處置、住院天數及醫療費用之關係,使用統計方法包含次數百分比及羅吉斯迴歸分析。 結果:2007年台灣0~4歲兒童傷害住院計4,117人,有進行手術處置者共2,146人(52%),住院者平均住院天數為5.29天,醫療總花費為193,480,710元。在病患特質方面,男童人數(n=2,391)是女童(n=1,726)的1.39倍;年齡以1歲所佔比例最高25.77%。在環境特質方面,醫院層級,以區域醫院比例最高53.33%;而都市化程度,以中都市化市鎮比例最高55.28%。在傷害特質方面,傷害類型以跌倒墜落比例最高(28.49%);受傷部位(診斷類型)以上肢及下肢骨折比例最高(15.5%)。另外,有關醫療利用型態方面,1歲兒童發生重複傷害的比例最高(28.19%);而發生傷害導致上下肢骨折較須進行手術處置(上肢OR=33.11,95%C.I.=14.50~75.58;下肢OR=15.92,95%C.I.=6.68~37.92);且有手術處置者住院天數與醫療費用分別比未手術處置者高出2.58天與52,810.5元。 結論:傷害造成的骨折對兒童身體及醫療資源的損耗均相當嚴重,相關單位應積極研擬防制策略,降低兒童傷害的發生。
Objective: The aim of this study was to understand the hospitalization characteristics of injured children aged 0-4 in Taiwan and to determine the patterns of utilization of their medical care. Methods: This research used data under external cause coding (E800~E999) from ”Inpatient expenditures by admissions (DD)” in the 2007 National Health Insurance Research Database for analysis. The statistical analysis was performed on such variables as patient characteristics (gender, age, and number of hospitalizations), environmental characteristics (hospital level and degree of urbanization), injury characteristics (types and location), and patterns of medical care utilization (surgical treatment, hospital stay, and cost). Logistic regression analysis was used to identify factors that influenced medical care utilization. Results: In 2007, there were 4,117 hospitalized injured children aged 0~4 in Taiwan. Of these, 2,146 (52%) required surgical treatment. The average hospital stay was 5.29 days, and the total medical cost was NT$193, 480, 710. For patient characteristics, the number of boys (2,391) was 1.39 times the number of girls (1,726) and the 1-year-olds had the highest proportion of admissions at 25.77% (n=1,061). For environmental characteristics, the regional hospitals had the highest percentage of admissions at 53.33% (n=2,196) while the town-based degree of urbanization showed the highest percentage at 55.28%. For injury characteristics, falls accounted for the highest percentage (28.49%); and fractures of upper and lower limbs were most common (15.5%). For patterns of medical care utilization, 1-year-olds had the most repeat injuries (28.19%). Upper and lower limb fractures required the most surgery (OR of upper limb=33.11, 95%C.I.=14.50~75.58; OR of lower limb=15.92, 95%C.I.=6.68~37.92). The hospital stays and medical expenses of surgical inpatients were highest at 2.58 days and NT$52,810.50. Conclusions: Childhood fractures result in physical damages and significant costs in medical resources. Authorities should develop prevention strategies to reduce childhood injuries.
期刊論文
1.王昱豐、徐美菁、林俊隆(2005)。病患安全及以病人為中心之醫療照護-兼論本院推動之經驗。慈濟護理,17(4),1-13。  延伸查詢new window
2.賴怜蜜、張立東、蔡明哲、謝秀幸、林佳蓉(20061200)。兒童事故傷害調查研究--以臺南某醫學中心為例。嘉南學報. 科技類,32,234-246。  延伸查詢new window
3.Thomas, Eric J.、Studdert, David M.、Burstin, Helen R.、Orav, E. John、Zeena, Timothy、Williams, Elliott J.、Howard, K. Mason、Weiler, Paul C.、Brennan, Troyen A.(2000)。Incidence and types of adverse events and negligent care in Utah and Colorado。Medical Care,38(3),261-271。  new window
4.杜友蘭、葉金川、林芸芸、趙秀雄(19800100)。臺北市幼稚園托兒所兒童意外災害流行病學之研究。醫學研究,3(3),951-966。  延伸查詢new window
5.劉介宇、洪永泰、莊義利、陳怡如、翁文舜、劉季鑫、梁賡義(20060600)。臺灣地區鄉鎮市區發展類型應用於大型健康調查抽樣設計之研究。健康管理學刊,4(1),1-22。new window  延伸查詢new window
研究報告
1.行政院衛生署(2009)。97年度死因統計記者會發布資料--死因統計結果分析。  延伸查詢new window
學位論文
1.鄧文蕙(1991)。幼兒家庭意外傷害與照顧者對幼兒意外傷害防範及處理之認識(碩士論文)。國防醫學院。  延伸查詢new window
圖書
1.Erikson, Erik Homburger(1963)。Childhood and Society。W. W. Norton Publishing Co.。  new window
其他
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2.World Health Organization(20091226)。Injury A Leading Cause of the Global Burden of Disease。  new window
3.行政院衛生署統計資料(20091212)。歷年事故傷害死亡人數、死亡率-按5歲年齡組分。  延伸查詢new window
4.World Health Organization(20091226)。Age-standardized mortality rate for injuries (per 1000 000 population) World Health Organization。  new window
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