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摘要
外文摘要
引文資料
題名:
急診病患三天內重返急診之相關因素分析:全人口代表性資料的研究
書刊名:
醫務管理期刊
作者:
廖茂宏
/
林韶穎
/
湯淑貞
/
陳靖宜
/
陳楚杰
作者(外文):
Liao, Mao-hung
/
Lin, Shao-ying
/
Tang, Shu-chen
/
Chen, Chin-yi
/
Chen, Chu-chieh
出版日期:
2017
卷期:
18:3
頁次:
頁177-201
主題關鍵詞:
急診
;
返診
;
全民健康保險
;
Emergency department
;
Return visits
;
National health insurance
原始連結:
連回原系統網址
相關次數:
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:
1
共同引用:
2
點閱:7
目的:探討病患、醫師及醫療機構相關特性與急診病患三天內重返急診的關係。方法:本研究使用國家衛生研究院發行之全民健康保險研究資料庫2000年百萬人歸人檔之資料,使用邏輯斯迴歸(logistic regression)探討影響急診病患三天內重返急診的相關因素,以SAS9.4統計套裝軟體進行資料整理與統計分析。結果:研究對象共計89,708位使用過急診的病患,其中4,860人(5.42%)三天內重返急診;2,879人(3.21%)因相同疾病診斷三天內重返急診,其中有1,160人(40.29%)重返不同醫院急診。男性病患、19歲以上病患、循環系統病患、消化系統病患、檢傷分類為第一、二、三級病患、區域及地區醫院病患、低度都市化病患、非公立醫院病患、低收入戶病患重返急診的機率較高。結論:影響急診病患三天內重返急診的相關因素為病患性別、病患年齡層別、疾病診斷類別、檢傷分類級數、投保地區都市化程度及機構層級別。相同疾病類別三天內重返急診者,有40.29%至不同的醫院急診,這種現象的原因值得進一步探討。
以文找文
Objectives: We analyzed the relationship between return visits to the emergency department (ED) within three days and various characteristics associated with patients, physicians and medical institutions. Methods: The longitudinal health insurance database of one million subjects randomly selected from all beneficiaries in 2000. All ED visits in 2013 were analyzed for return visits to the ED within three days. A multivariate logistic regression analysis was utilized to evaluate the independent effect of various characteristics of return visits to the ED within three days. Results: The overall rate of return visits to the ED within three days was 5.42% (4,860/89,708). The overall rate of return visits to the ED with the same diagnosis category within three days was 3.21% (2,897/89,708). Of these 2,897 return visits, 1,160 (40.29%) returned to the ED of a different hospital. Being male, aged >=19, ED visits within a diagnostic category of endocrine system or circulatory system, ED visits to regional hospitals or district hospitals, ED visits with triage acuity scales one, two, or three, subjects living in areas with a low level of urbanization, subjects on welfare, and ED visits to non-public hospitals independently increased the risk of return visits to the ED within three days. Conclusions: The risk of return visits to the ED within three days was associated with demographic characteristics, diagnosis at the initial ED visit, accreditation level of the hospital, and triage acuity scale. We noted that a large proportion (40.29%) of patients with the same diagnosis category made return visits to a different hospital. The reasons for this phenomenon warrant further investigation.
以文找文
期刊論文
1.
Lindsay, P.、Schull, M.、Bronskill, S.、Anderson, G.(2002)。The development of indicators to measure the quality of clinical care in emergency departments following a modified-delphi approach。Academic Emergency Medicine,9(11),1131-1139。
2.
Trivedy, C. R.、Cooke, M. W.(2015)。Unscheduled return visits (URV) in adults to the emergency department (ED): A rapid evidence assessment policy review。Emergency Medicine Journal,32(4),324-329。
3.
陳世雄、胡百敏、廖浩欽、廖訓禎(20091200)。以全民健康保險研究資料庫之抽樣歸人檔資料分析急診病人就醫後流向。臺灣急診專科醫師期刊,1(1),11-21。
延伸查詢
4.
黃耀緯、游斯雯、簡戊鑑(20101200)。老年群體急診醫療利用與非計劃性返診之探討。臺灣老人保健學刊,6(2),158-167。
延伸查詢
5.
葉時烊、胡百敏、廖浩欽、林作彥、王少谷、廖訓禎(20100300)。急診病人三日內重返急診之分析:全民健康保險研究資料庫之抽樣歸人檔資料分析。臺灣急診專科醫師期刊,2(1),6-13。
延伸查詢
6.
Banks, I.(2001)。No man's land: Men, illness, and the NHS。British Medical Journal,323(7320),1058-1060。
7.
Blom, M. C.、Jonsson, F.、Landin-Olsson, M.、Ivarsson, K.(2014)。Associations between in-hospital bed occupancy and unplanned 72-h revisits to the emergency department: a register study。International Journal of Emergency Medicine,7(1),25。
8.
Bronstein, J. M.、Johnson, V. A.(1997)。How rural physicians compare on cost and quality measures for Medicaid ambulatory care episodes。The Journal of Rural Health,13(2),126-135。
9.
Foran, A.、Wuerth-Sarvis, B.、Milne, W. K.(2010)。Bounce-back visits in a rural emergency department。Canadian Journal of Rural Medicine,15(3),108-112。
10.
Hu, K. W.、Lu, Y. H.、Lin, H. J.、Guo, H. R.、Foo, N. P.(2012)。Unscheduled return visits with and without admission post emergency department discharge。The Journal of Emergency Medicine,43(6),1110-1118。
11.
Ko, M.、Lee, Y.、Chen, C.、Chou, P.、Chu, D.(2015)。Incidence of and predictors for early return visits to the emergency department: A population-based survey。Medicine,94(43),e1770。
12.
Kuan, W. S.、Mahadevan, M.(2009)。Emergency unscheduled returns: Can we do better?。Singapore Medical Journal,50(11),1068-1071。
13.
Lerman, B.、Kobernick, M. S.(1987)。Return visits to the emergency department。Journal of Emergency Medicine,5(5),359-362。
14.
廖訓禎、卜樂得、胡百敏、陳日昌、廖浩欽(19990600)。Rates and Causes of Emergency Department Revisits within 72 Hours。臺灣醫學會雜誌,98(6),422-425。
延伸查詢
15.
Lishner, D. M.、Rosenblatt, R. A.、Baldwin, L. M.、Hart, L. G.(2000)。Emergency department use by the rural elderly。Journal of Emergency Medicine,18(3),289-297。
16.
Norton, C. H.、McManus, M. A.(1989)。Background tables on demographic characteristics, health status, and health services utilization。Health Services Research,23(6),725-756。
17.
O'Dwyer, F.、Bodiwala, G. G.(1991)。Unscheduled return visits by patients to the accident and emergency department。Emergency Medicine Journal,8(3),196-200。
18.
Pinkhasov, R. M.、Wong, J.、Kashanians, J.、Lee, M.、Samadi, D. B.、Pinkhasov, M. M.、Shabsigh, R.(2010)。Are men shortchanged on health? Perspective on health care utilization and health risk behavior in men and women in the United States。International journal of clinical practice,64(4),475-487。
19.
Shao, Chun-chih、Chang, Chia-pei、Chou, Li-fang、Chen, Tzeng-ji、Hwang, Shinn-jang(20110900)。The Ecology of Medical Care in Taiwan。Journal of the Chinese Medical Association,74(9),408-412。
20.
Verelst, S.、Pierloot, S.、Desruelles, D.、Gillet, J. B.、Bergs, J.(2014)。Short-term unscheduled return visits of adult patients to the emergency department。Journal of Emergency Medicine,47(2),131-139。
21.
王瀚儀、周義、龔嘉德、鍾昆融、李文輝(20070900)。The Use of Charlson Comorbidity Index for Patients Revisiting the Emergency Department within 72 Hours。長庚醫學,30(5),437-444。
延伸查詢
22.
Weiner, J. P.、Parente, S. T.、Garnick, D. W.、Fowles, J.、Lawthers, A. G.、Palmer, R. H.(1995)。Variation in office-based quality-a claims-based profile of care provided to Medicare patients with diabetes。The Journal of the American Medical Association,273(19),1503-1508。
23.
Wu, C. L.、Wang, F. T.、Chiang, Y. C.、Chiu, Y. F.、Lin, T. G.、Fu, L. F.、Tsai, T. L.(2010)。Unplanned emergency department revisits within 72 hours to a secondary teaching referral hospital in Taiwan。The Journal of Emergency Medicine,38(4),512-517。
24.
Ionescu-Ittu, R.、McCusker, J.、Ciampi, A.、Vadeboncoeur, A. M.、Roberge, D.、Larouche, D.、Pineault, R.(2007)。Continuity of primary care and emergency department utilization among elderly people。Canadian Medical Association journal,177(11),1362-1368。
25.
Keith, K. D.、Bocka, J. J.、Kobernick, M. S.、Krome, R. L.、Ross, M. A.(1989)。Emergency department revisits。Annals of Emergency Medicine,18(9),964-968。
研究報告
1.
衛生福利部中央健康保險署(2013)。2013-2014年全民健康保險年報。臺北:衛生福利部。
延伸查詢
其他
1.
Institute of Medicine(2005)。Quality Through Collaboration: The Future of Rural Health,http://www.nap.edu/read/11140/chapter/1。
圖書論文
1.
Gregory, L. H.(1991)。Specific high-risk medicolegal issues。Emergency Medicine Risk Management: A comprehensive review。American College of Emergency Physicians。
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