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題名：臺灣地區兒童急診醫療利用及其相關因素之研究
書刊名：臺灣公共衛生雜誌
作者：沈希哲／胡鎮如／李中一／柯明中 引用關係／陳楚杰 引用關係
作者(外文)：Shen, Hsi-che／Hu, Cheng-ju／Li, Chung-yi／Ko, Ming-chung／Chen, Chu-chieh
出版日期：2015
卷期：34:1
頁次：頁50-60
主題關鍵詞：兒童；急診醫療利用；全民健康保險研究資料庫；Children；Emergency medical care utilization；National health insurance research database；NHIRD
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:10
  • 點閱點閱:45
目標：本研究旨在探討我國兒童急診醫療利用情形，及影響兒童急診醫療利用及成為經常利用急診醫療者的相關因素。方法：使用國家衛生研究院發行之全民健康保險研究資料庫的2005年百萬人抽樣歸人檔，以得到兒童急診醫療利用的資料。使用複邏輯斯迴歸分析影響兒童急診醫療利用及成為經常利用急診醫療者的因素。結果：2005年我國全民健康保險的被保險人中兒童共計有233,382位，有43,976人(18.84%)共使用急診醫療65,839人次。在利用急診醫療方面，男童、都市兒童、有重大傷病兒童及門診次15次以上兒童利用急診醫療的機率較高，相較於未滿1歲兒童，1歲至6歲兒童利用急診醫療的機率較高，但7歲以上兒童則較低。在成為經常利用急診醫療者方面，男童、未滿1歲兒童、有重大傷病兒童、門診次15次以上兒童、都市兒童成為經常利用急診醫療者的機率較高。結論：男童、有重大傷病兒童、門診利用次數多的兒童、都市兒童，其利用急診醫療及成為經常利用急診醫療者的機率較高。
Objectives: This study aimed to determine emergency medical care (EMC) utilization among children in Taiwan and factors associated with EMC utilization. Methods: This was a populationbased study using the Longitudinal Health Insurance Database of 2005 (LHID 2005), which was released by the National Health Research Institutes. All emergency department visits among children ＜18 years of age in 2005 were analyzed to determine the rates and factors associated with EMC utilization. A multivariate logistic regression model was used to assess the independent effect of various characteristics on the risk of EMC utilization. Results: Of 233,382 children, 43,976 (18.84%) had emergency department visits accounting for 65,839 emergency department visits. Compared with girls, boys were more likely to utilize EMC. Compared with children ＜ 1 year of age, children 1-6 years of age had a higher risk of utilizing EMC. Compared with children living in urban areas, children living in suburban areas were less likely to utilize EMC. Children with catastrophic diseases were more likely to use EMC. Children with ≤ 15 outpatient department visits had a lower risk of EMC utilization compared to children with 16-20 and ≥ 21 outpatient department visits. Boys were more likely to have frequent EMC utilization. Compared with children ＜ 1 year of age, children 7-11 or 12-17 years of age had a lower risk of frequent EMC utilization. Children with catastrophic diseases were more likely to have frequent EMC utilization. Children with ≤ 15 outpatient department visits had a lower risk of frequent EMC utilization than children with 16-20 and ≥ 21 outpatient department visits. Conclusions: Boys, children with catastrophic diseases, children living in urban areas, and children with more outpatient department visits were more likely to utilize EMC and have frequent EMC utilization.
期刊論文
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2.曾柏昌、胡百敏、廖浩欽、黃紀倫、廖訓禎(200912)。非特異性徵候症狀之急診病人初探：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，1(1)，22-28。  延伸查詢new window
3.廖晏辰、胡百敏、廖浩欽、林作彥、葉美枝(20100600)。以全民健康保險研究資料庫之承保抽樣歸人檔分析急診就醫後死亡之病人。臺灣急診專科醫師期刊，2(2)，39-47。  延伸查詢new window
4.黃金安、蔡文正、陳音潔、胡為雄、楊大羽(200304)。Factors Associated with Frequent Use of Emergency Services in a Medical Center。臺灣醫學會雜誌，102(4)，222-228。  延伸查詢new window
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8.黃金安、賴其勛、胡哲生(2006)。急診醫療服務與其它醫療服務之類別間關係。台灣衛誌，25，384-393。new window  延伸查詢new window
9.Garcia, T. C.、Bernstein, A. B.、Bush, M. A.(2010)。Emergency department visitors and visits: who used the emergency room in 2007?。National Center for Health Statistics Data Brief，38，1-8。  new window
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11.Burt, C. W.、McCaig, L. F.(2006)。Staffing, Capacity, and Ambulance Diversion in Emergency Departments: United States, 2003-2004。Advance Data from Vital and Health Statistics，376。  new window
12.Hunt, K. A.、Weber, E. J.、Showstack, J. A.、Colby, D. C.、Callaham, M. L.(2006)。Characteristics of frequent users of emergency departments。Annals of Emergency Medicine，48(1)，1-8。  new window
13.Lambe, S.、Washington, D. L.、Fink, A.(2002)。Trends in the use and capacity of California's emergency departments。Ann Emerg Med，39，389-396。  new window
14.Nawar, E. W.、Niska, R. W.、Xu, J.(2007)。National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary。National Health Statistics Reports，386。  new window
15.Niska, R.、Bhuiya, F.、Xu, J.(2010)。National Hospital Ambulatory Medical Care Survey: 2007 Emergency Department Summary。National Health Statistics Reports，26。  new window
16.Timm, N. L.、Ho, M. L.、Luria, J. W.(2008)。Pediatric emergency department overcrowding and impact on patient flow outcomes。Academic Emergency Medicine，15(9)，832-837。  new window
17.Xu, K. T.、Nelson, B. K.、Berk, S.(2009)。The changing profile of patients who used emergency department services in the United States: 1996 to 2005。Annals of Emergency Medicine，54(6)，805-810。  new window
18.Ben-Isaac, E.、Schrager, S. M.、Keefer, M.、Chen, A. Y.(2010)。National profile of nonemergent pediatric emergency department visits。Pediartics，125，454-459。  new window
19.Berry, A.、Brousseau, D.、Brotanek, J. M.、Tomany-Korman, S.、Flores, G.(2008)。Why do parents bring children to the emergency department for nonurgent conditions? A qualitative study。Ambul Pediatr，8，360-367。  new window
20.Kroner, E. L.、Hoffmann, R. G.、Brousseau, D. C.(2009)。Emergency department reliance: a discriminatory measure of frequent emergency department users。Pediartics，125，133-138。  new window
21.Suruda, A.、Burns, T. J.、Knight, S.、Dean, J. M.(2005)。Health insurance, neighborhood income, and emergency department usage by Utah children 1996-1998。BMC Health Serv Res，5，29-34。  new window
22.Brousseau, D. C.、Gorelick, M. H.、Hoffmann, R. G.、Flores, G.、Nattinger, A. B.(2009)。Primary care quality and subsequent emergency department utilization for children in Wisconsin Medicaid。Acad Pediatr，9，33-39。  new window
23.胡勝川、顏鴻章、高偉峰(20011200)。東部某醫學中心急診之人口學及品質檢討。慈濟醫學，13(4)，223-229。  延伸查詢new window
24.Gruneir, A.、Bell, C. M.、Bronskill, S. E.、Scbull, M.、Anderson, G. M.、Rocbon, P.(2010)。Frequency and pattern of emergency department visits by long-term care residents: a population-based study。J Am Geriatr Soc，58，510-517。  new window
25.Li, G.、Lau, J.T.、McCarthy, M. L.、Schull, M. J.、Vermeulen, M.、Kelen, G. D.(2007)。Emergency department utilization in the United States。Acad Emerg Med，14，582-584。  new window
26.Shah, M. N.、Cushman, J. T.、Davis, C. O.、Bazarian, J. J.、Auinger, P.、Friedman, B.(2008)。The epidemiology of emergency medical services use by children: an analysis of the national hospital ambulatory medical care survey。Prehosp Emerg Care，12，269-276。  new window
27.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new window
28.Owens, P. L.、Zodet, M. W.、Berdahl, T.、Dougherty, D.、McCormick, M. C.、Simpson, L. A.(2008)。Annual report on health care for children and youth in the United States: focus on injury-related emergency department utilization and expenditures。Ambul Pediatr，8，219-240。  new window
29.Hirshon, J. M.、Weiss, S. R.、Locasale, R.、Levine, E.、Blaisdell, C. J.(2006)。Looking beyond urban/rural differences: emergency department utilization by asthmatic children。J Asthma，43，301-306。  new window
30.Sharma, V.、Simon, S. D.、Bakewell, J. M.、Ellerbeck, E. F.、Fox, M. H.、Wallace, D. D.(2000)。Factors influencing infant visits to emergency departments。Pediatrics，106，1031-1039。  new window
31.Ludwick, A.、Fu, R.、Warden, C.、Lowe, R. A.(2009)。Distances to emergency department and to primary care provider's office affect emergency department use in children。Acad Emerg Med，16，411-417。  new window
32.吳秋芬、吳肖琪、石富元、許銘能(20081200)。影響急診病患暫留時間之相關因素探討。臺灣公共衛生雜誌，27(6)，507-518。new window  延伸查詢new window
33.周歆凱、黃興進、蔡明足、翁林仲、蘇喜、陳真吟(20090700)。運用資料探勘之叢集分析技術探討急診72小時再返診病患特性。澄清醫護管理雜誌，5(3)，13-20。  延伸查詢new window
34.許君強、林澤余、沈希哲、張嘉莉、湯澡薰(20060300)。醫療補貼政策對醫療利用之影響--以臺北市兒童醫療補助計畫為例。北市醫學雜誌，3(3)，268-287。  延伸查詢new window
35.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
36.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
37.Mustard, C. A.、Kozyrskyj, A. L.、Barer, M. L.、Sheps, S.(1998)。Emergency Department Use as a Component of Total Ambulatory Care: A Population Perspective。Canadian Medical Association Journal，158，49-55。  new window
研究報告
1.McCaig, L. F.、Nawar, E. W.(2006)。National Hospital Ambulatory Medical Care Survey: 2004 Emergency Department Summary。Hyattsville, MD：National Center for Health Statistics。  new window
學位論文
1.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(碩士論文)。國立陽明大學，臺北。  延伸查詢new window
2.鄭生芳(2008)。臺灣地區急診（高）使用者就醫頻率及趨勢分析(碩士論文)。高雄醫學大學。  延伸查詢new window
3.陳靜誼(2005)。醫院規模與急診病患照護結果(碩士論文)。國立陽明大學，臺北。  延伸查詢new window
4.楊正偉(2008)。兒童急診醫療利用及品質之探討(碩士論文)。國立陽明大學，臺北。  延伸查詢new window
5.張齡芝(2006)。北臺灣醫院急診於白天、傍晚及夜間醫療利用之分析(碩士論文)。元智大學，新北市。  延伸查詢new window
6.李松澤(2011)。影響兒童急診醫療品質指標之研究(碩士論文)。輔仁大學。  延伸查詢new window
圖書
1.Institute of Medicine(2006)。Hospital-Based Emergency Care: At the Breaking Point。National Academies Press。  new window
其他
1.法務部。兒童及少年福利與權益保障法，http://law.moj.gov.tw/lawclass/lawall.aspx?pcode=d0050001， 2014/04/15。  延伸查詢new window
2.衛生福利部(2011)。衛生統計系列，http://www.mohw.gov.tw/， 2011/10/06。  延伸查詢new window
3.United Nations(1990)。Convention on the Rights of the Child，http://www.ohchr.org/CH/Issues/Documents/other_instruments/24.PDF.， 2011/10/15。  new window
4.台灣兒科醫學會(2007)。學會公告，http://www.pediatr.org.tw/news/news_info.asp?id=129， 2011/11/04。  new window
5.行政院主計總處(1993)。台灣地區都會區分類，http://www.dgbas.gov.tw/ct.asp?xItem=27078&ctNode=3378， 2011/08/26。  延伸查詢new window
 
 
 
 
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