The Impact of Intensivists in the Quality of Critical Care Medicine

重症專任主治醫師對重症醫療照護品質之影響

丁毅(Yih Ting) ； 廖訓禎(Shiumn-Jen Liaw) ； 胡百敏(Pai-Min Hu) ； 廖浩欽(How-Chin Liao) ； 吳銘斌(Ming-Pin Wu) ； 許文祥(Boon-Siang Khor) ； 葉美枝(Mei-Chih Yeh)

《中華民國急救加護醫學會雜誌》 21卷2期 (2010/06) Pp. 74-82

https://doi.org/10.30018/JECCM.201006.0002

摘要

目的：瞭解重症專任主治醫師專責加護病房(intensive care unit, ICU)之影響。
方法：蒐集2003年3月至8月（重症專任主治醫師進驻前）、2003年9月至2004年2月（進驻後）及2005年3月至8月（進驻後一年六個月）三個時段，ICU所有病人基本資料及病房行政與品管資料，主要結果變項為病人ICU死亡率、ICU平均住院日及相關品管指標。
結果：重症專任主治醫師進驻後，ICU平均住院日、重返率、感染率及疾病嚴重度中度病人之死亡率均有顯著性降低，佔床率、動脈導管及中心靜脈導管使用率呈現顯著性的下降。
結論：ICU採重症專任主治醫師制度可改善疾病嚴重度中度病人的死亡率及相關照護品質。

關鍵字

重症專任主治醫師 ； 重症醫療 ； 醫療品質

並列摘要

Study purpose: To investigate the impact of an intensivist in charge of a general intensive care unit (ICU) in a regional hospital.
Method: Patient data were retrospectively reviewed before (March to August, 2003) and after (September. 2003 to February, 2004 and March to August, 2005) intensivists were in charge of an ICU. The major outcomes were ICU mortality rate, ICU length of stay (LOS) and other quality indicators.
Results: After intensivists were in charge of the ICU, the ICU LOS, unexpected return rate, indicators rate and mortality rate of patients with moderate severity were significantly decreased. The bed occupancy rate and the utilization rate of arterial lines and central venous catheters also decreased significantly.
Conclusion: A system using intensivists in a general ICU can decrease the mortality rate, the ICU LOS and the ICU return rate of patients with moderate severity.

並列關鍵字

intensivist ； intensive medical care ； quality of intensive care