台北市十一家急救責任醫院急診室之使用適當性評估

Appropriateness of the Emergency Department Utilization at Eleven Major Hospitals in Taipei City

姜錦燁(Chin-Yeh Chiang) ； 王榮德(Jung-Der Wang)

《中華民國公共衛生學會雜誌》 6卷3期 (1987/02) Pp. 56-73

https://doi.org/10.6288/JNPHARC1986-06-03-05

摘要

從台北市十一家急救責任醫院，於民國七十一年間分層隨機抽取7,314名急診病人的急診病歷資料，分析其急診條件以評估台北市緊急醫療照護系統被民眾不適當使用的程度。研究者根據目前十一家醫院現用的急診標準，訂出一套評估指標進行評估。結果合乎此套評估指標（稱之爲眞急診）的百分率爲69.4%。其它各性質的真急診百分率比較結果爲：公立醫院高於私立醫院，男性高於女性，10~29歲和70歲以上較其它年齡組爲高，大夜斑高於白斑和晚班，周間高於假日。呼吸系疾病和醫院的員工與眷屬的眞急診百分率較低。眞急診百分率在四季和不同的居住地並沒有多大差異。建議請專家學者組成委員會，根據現有急診標準並參考本研究所用之各種指標，共同訂出一套急診標準推介各醫院使用，並定期評估急診資源使用的適當性，以增進急診資源之使用。

關鍵字

急診標準 ； 評估 ； 眞急診

並列摘要

The purpose of the study was to determine the appropriateness of the emergency service utilization in Taipei. We abstracted 7, 314 medical records from the emergency departments of eleven major hospitals and evaluated the percentage of true emergency' according to a combined criteria of eleven major hospitals and modified by the authors. The results showed that 69.4% of emergency visits were truly emergent. Public hospitals were more likely to have higher percentages of true emergency than those of private hospitals. The percentages of true emergency for upper respiratory tract infections, gastrointestinal infections, and hypertension were 48.0%, 45.5%, and 37.7%, respectively, which were the major sources of nonemergent visits. Families of hospital employees' and children during age of 0 and 4, were more likely to use the emergency services inappropriately. There was no significant difference on the utilization of emergency service if stratified by the categories of season and residence place. We recommend that a uniformed criteria for emergency visits sh9uld be set up through an expert committee on this field in order that hospitals can put on practice and future evaluation can be done periodically.

並列關鍵字

emergency criteria ； evaluation ； true emergency