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題名:住院病人跌倒事件之原因分析及醫療成本
書刊名:護理雜誌
作者:林美惠 引用關係陳淑如 引用關係廖美南陳勇志張文英
作者(外文):Lin, Mei-huiChen, Su-ruLiao, Mei-nanChen, Yung-chihChang, Wen-yin
出版日期:2017
卷期:64:4
頁次:頁44-52
主題關鍵詞:跌倒住院病人醫療成本FallsInpatientsMedical costs
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(1) 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:1
  • 共同引用共同引用:12
  • 點閱點閱:2
背景:跌倒是醫院中常見的不良事件,但病人一旦跌倒後,可能會造成個人、家庭在經濟和照護上的負擔。目的:分析住院病人發生跌倒之原因及跌倒後之住院天數與醫療處置費用。方法:本研究為回溯性配對個案控制設計。資料來源為北部某區域醫院,2009年至2011年間住院且發生跌倒的病人,而對照組為無跌倒的病人,以性別、年齡 ± 5歲、主診斷ICD-9-CM(InternationalClassification of Diseases, Ninth Revision, Clinical Modification)相同者為配對條件。資料統計方法包括描述性與推論性統計。結果:本研究共收160位住院病人(跌倒組80位及對照組80位)。結果發現住院期間跌倒的病人,有過去跌倒經驗與平均總住院天數較對照組多。經多項式羅吉斯迴歸分析後,與住院病人跌倒之三個危險因子為:無陪伴者、有使用易跌倒藥物 ≥ 三類及無點滴注射者。本研究也發現,隨著跌倒後之傷害級數增加,其醫療處置成本支出也隨之增加,其中,又以三級傷害程度的醫療處置費用最多,佔75.6%,其平均每位跌倒的醫療成本約新台幣18,257元。結論/實務應用:本研究結果能作為未來醫院在推動病人安全與預防病人跌倒之參考,以減少額外的醫療成本支出。
Background: Patient falls are a common, adverse event in hospitals that may result in economic and care burdens on the patient and his/her family afterward. Purpose: To analyze the factors that relate to falls among inpatients and to estimate the associated days of hospitalization and medical costs. Methods: The present study used a retrospective matched case-control design to analyze inpatient fall data for 2009 to 2011 from a regional teaching hospital in northern Taipei. We matched fallers and controls according to gender, age ± 5 years, and ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) code. Data were analyzed using descriptive and inferential statistics. Results: A total of 160 inpatients participated in the present study (80 fallers in the fall group and 80 nonfallers in the control group). The results revealed that fallers had more previous fall experiences and longer hospital stay than nonfallers. Multiple logistic regression analysis revealed that the risk factors that were significantly associated with inpatient falls included: no family accompaniment, use of more than 3 fall-related medications, and no intravenous catheter placement. Results further found that medical costs increased with the degree of injury. Third-degree injuries bore the highest post-fall medical costs of all of the injury-degree categories. The average medical cost for patients with third-degree injuries was 18,257 New Taiwan dollars. Conclusion / Implications for Practice: The findings provide a reference for hospitals to promote patient safety, to prevent the occurrence of inpatient falls, and, ultimately, to reduce fall-associated medical costs.
期刊論文
1.Chen, Y. C.、Chien, S. F.、Chen, L. K.(2008)。Risk Factors Associated with Falls Among Chinese Hospital Inpatients in Taiwan。Archives of Gerontology and Geriatrics,48(2),132-136。  new window
2.Chang, C. M.、Chen, M. J.、Tsai, C. Y.、Ho, L. H.、Hsieh, H. L.、Chau, Y. L.(2011)。Medical conditions and medications as risk factors of falls in the inpatient older people: a case-control study。International Jounral of Geriatric Psychiatry,26,602-607。  new window
3.吳美雯、蔡慈娟、陶阿倫、陳立昇、伍福生(20110700)。住院病人跌倒後造成傷害因素分析--以通報資料庫為例。醫療品質雜誌,5(4),64-69。new window  延伸查詢new window
4.Boswell, D. J.、Ramsey, J.、Smith, M. A.、Wagers, B.(2001)。The cost-effectiveness of a patient-sitter program in an acute care hospital: A test of the impact of sitters on the incidence of falls and patient satisfaction。Quality Management in Health Care,10(1),10-16。  new window
5.Callis, N.(2016)。Falls prevention: Identification of predictive fall risk factors。Applied Nursing Research,29,53-58。  new window
6.Chang, C. M.、Lin, H. F.、Chiang, H. H.(2015)。A study on the relationship between age and inpatient falls in Taiwan。International Journal of Nursing Practice,21(5),605-611。  new window
7.Chiu, M. H.、Lee, H. D.、Hwang, H. F.、Wang, S. C.、Lin, M. R.(2015)。Medication use and fall-risk assessment for falls in an acute care hospital。Geriatrics & Gerontology International,15(7),856-863。  new window
8.Hirose, M.、Nakabayashi, N.、Fukuda, S.、Yamaguchi, S.、Igawa, M.、Egami, K.、Shima, H.(2015)。Additional medical costs due to hospital-acquired falls。Journal of Patient Safty。  new window
9.Hou, W. H.、Kang, C. M.、Ho, M. H.、Kuo, J. M.、Chen, H. L.、Chang, W. Y.(2017)。Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients。Journal of Clinical Nursing,26(5/6),698-706。  new window
10.Kozono, A.、Isami, K.、Shiota, K.、Tsumagari, K.、Nagano, M.、Inoue, D.、Yamamichi, K.(2016)。Relationship of prescribed drugs with the risk of fall in inpatients。藥學雜誌,136(5),769-776。  new window
11.Krauss, M. J.、Evanoff, B.、Hitcho, E.、Ngugi, K. E.、Dunagan, W. C.、Fischer, I.、Fraser, V. J.(2005)。A case-control study of patient, medication, and care-related risk factors for inpatient falls。Journal of General Internal Medicine,20(2),116-122。  new window
12.Pearce, L.(2017)。Preventing falls in hospital。Nursing Management,23(10),11。  new window
13.Lam, C. F.、Hsieh, S. Y.、Wang, J. H.、Pan, H. S.、Liu, X. Z.、Ho, Y. C.、Chen, T. Y.(2016)。Incidence and characteristic analysis of in-hospital falls after anesthesia。Perioperative Medicine,5。  new window
14.Lam, C.、Kang, J. H.、Lin, H. Y.、Huang, H. C.、Wu, C. C.、Chen, P. L.(2016)。First fall-related injuries requiring hospitalization increase the risk of recurrent injurious falls: A nationwide cohort study in Taiwan。PLoS ONE,11(2),e0149887。  new window
15.Lawlor, D. A.、Patel, R.、Ebrahim, S.(2003)。Assocaiation between falls in elderly woman and chronic diseases and drug use: Cross sectional study。British Medical Journal,327(7417),712-717。  new window
16.Morello, R. T.、Barker, A. L.、Watts, J. J.、Haines, T.、Zavarsek, S. S.、Hill, K. D.、Stoelwinder, J. U.(2015)。The extra resource burden of in-hospital falls: A cost of falls study。The Medical Journal of Australia,203(9),367。  new window
17.Zecevic, A. A.、Chesworth, B. M.、Zaric, G. S.、Huang, Q.、Salmon, A.、McAuslan, D.、Brunton, D.(2012)。Estimating the cost of serious injurious falls in a Canadian acute care hospital。Canadian Journal on Aging,31(2),139-147。  new window
18.Silkworth, A. L.、Baker, J.、Ferrara, J.、Wagner, M.、Gevaart, M.、Morin, K.(2016)。Nursing staff develop a video to prevent falls: A quality improvement project。Journal of Nursing Care Quality,31(1),40-45。  new window
19.陳玉枝、林麗華、簡淑芬(20020900)。住院病患傷害性跌倒的影響因素與其醫療資源耗用之相關性。慈濟護理雜誌,1(3),66-77。  延伸查詢new window
20.洪如慧、李佩樺、張育菘、張偉洲(20050600)。住院病患跌倒事件探討分析。福爾摩莎醫務管理雜誌,1(1),87-96。  延伸查詢new window
21.林小玲、溫明寰、陳玉枝(20100300)。跌倒危險評估量表準確度之研究。醫護科技期刊,12(1),47-59。new window  延伸查詢new window
其他
1.衛生福利部(2015)。台灣病人安全通報系統--2015年年報,http://www.patientsafety.mohw.gov.tw/Content/Downloads/List01.aspx?SiteID=1&MmmID=621273303702500244。  延伸查詢new window
2.Joint Commission on Accreditation Healthcare Organization(20150928)。Sentinel Event Alert 55: Preventing falls and fall-related injuries in health care facilities,https://www.jointcommission.org/sea_issue_55/。  new window
 
 
 
 
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