急診近期返診之探討：以南投市某地區醫院為例

Survey of Emergency Department Revisits in a Local Hospital in Nantou

洪世昌(Shih-Chang Hung) ； 賴世偉(Shih-Wei Lai) ； 李亞欣(Ya-Hsin Li) ； 謝豐年(Feng-Nian Xie) ； 陳玉如(Yu-Ru Chen) ； 劉翎玲(Lin-Ling Liu)

《中華民國急救加護醫學會雜誌》 21卷S期 (2010/12) Pp. 21-27

https://doi.org/10.30018/JECCM.201012.0016

摘要

目的：「急診室之近期非預期性返診」是評估醫院急診室整體品質的指標之一。過去大部分的研究都以大型醫院急診室為主，此研究則探討地區醫院急診室之近期返診情況。
方法：本研究為一回溯性調查。以南投地區某一地區醫院急診室為塞礎，調查2005年10月1日起至2005年12月31日止的急診說醫紀錄。研究中，急診72小時近期返診的原因分類變項包括四類(1)醫師／醫療因素(2)病人因素(3)疾病因素(4)其他因素。有關病患返診原因由急診醫療品質委員會，包括急診醫師、急診護理長，及一位加護病房工作人員依據病歷記載獨立決定，若意見相同者，則納入各分類統計數；若有差異，則由急診醫療品質委員會共同討論之後決定；討論後無法取得共識者，則歸類於第四類因素。
結果：急診72小時近期返診比率為3.4%。兩次急診說診病人返診主訴以發燒最多，佔所有返診主訴的31.6%，其次則為頭暈(11.4%)與腹痛(9.6%)。5歲以下的兒童病．色最容易因為發燒、呼吸道疾病而返診(77.8%)。老年病患返診後，急診醫師較傾向於安排病患住院。
結論：老年人與5歲以下的兒童都是地區醫院急診室容易近期返診的族群，急診醫師應多加注意。

關鍵字

非預期返診 ； 地區醫院 ； 急診 ； 醫療品質

並列摘要

Objectives: ”Unscheduled returns to the emergency department (ED)” is an indicator used to evaluate emergency department performance. These studies are usually conducted in medical centers. Our study was conducted in a local community hospital.
Methods: This was a hospital-based retrospective study. Data on emergency department visits from October 1 to December 31, 2005 were analyzed. Patients who revisited the ED within 72 hours of a first visit were selected for further analysis.
Results: The rate of revisits within 72 hours was 3.4%. The most common complaint of patients revisiting the ED was fever, followed by dizziness and abdominal pain. Children under 5 years old usually returned to the ED because of fever and respiratory tract diseases. Elderly patients were more likely to be admitted to the hospital after revisiting the ED.
Conclusions: ED physicians should pay more attention to the elderly patients and children under 5 years old to reduce the rate of revisits and improve the quality of ED care.

並列關鍵字

unscheduled returns ； local hospital ； emergency department ； quality