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急診醫療服務與其它醫療服務之類別間關係

Relationship of Utilization of Emergency Medical Services and Other Medical Services

摘要


Objectives: Following implementation of the global budget payment system, understanding the relationships between service use between specialties has become essential for hospital management and health policy makers. The purpose of this study was to explore the intercategorical relationships of emergency and other medical services. Methods: This study used nationwide claims data for the year 2001 from the National Health Insurance Research Database in Taiwan. Data from 6,996 insured individuals who had used emergency medical services were included. Multiple regression and logistic regression analyses were used to determine relationships among various medical services. Results: Elderly patients, patients who frequently used outpatient (OPD) services, and patients with frequent admissions tended to be frequent ED users (p<0.001). High utilization of outpatient and primary care services and frequent hospital admissions were significantly correlated with emergency service use after controlling for age and gender (p<0.001). Odds Ratios were 10.29 (95% CI: 7.65-13.84), 5.43 (4.15-7.11), and 1.46 (1.11-1.93), respectively, for outpatient use, hospital admissions, and primary care use. Conclusion: Hospital OPD use, hospital admission and primary care use all have an impact on ED use. Frequent ED users are more likely to use other medical services. In other words, there is an intercategorical relationship between ED use and use of other medical services.

並列摘要


Objectives: Following implementation of the global budget payment system, understanding the relationships between service use between specialties has become essential for hospital management and health policy makers. The purpose of this study was to explore the intercategorical relationships of emergency and other medical services. Methods: This study used nationwide claims data for the year 2001 from the National Health Insurance Research Database in Taiwan. Data from 6,996 insured individuals who had used emergency medical services were included. Multiple regression and logistic regression analyses were used to determine relationships among various medical services. Results: Elderly patients, patients who frequently used outpatient (OPD) services, and patients with frequent admissions tended to be frequent ED users (p<0.001). High utilization of outpatient and primary care services and frequent hospital admissions were significantly correlated with emergency service use after controlling for age and gender (p<0.001). Odds Ratios were 10.29 (95% CI: 7.65-13.84), 5.43 (4.15-7.11), and 1.46 (1.11-1.93), respectively, for outpatient use, hospital admissions, and primary care use. Conclusion: Hospital OPD use, hospital admission and primary care use all have an impact on ED use. Frequent ED users are more likely to use other medical services. In other words, there is an intercategorical relationship between ED use and use of other medical services.

被引用紀錄


簡任玉(2012)。醫療機構急診流程模擬效率最佳化之探討〔碩士論文,中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834/CSMU.2012.00156
顧勝敏(2011)。台灣高齡老人的醫療服務使用情形〔碩士論文,中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834/CSMU.2011.00177
李彥儫(2014)。老人脆弱狀況與醫療服務利用之關係〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833/CJCU.2014.00132
賴姿伶(2014)。探討地區剝奪程度、個人社經地位與台灣中高齡者醫療利用之影響〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831/TMU.2014.2014.00117
李偉民(2014)。台灣醫院急診利用的影響因素分析〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831/TMU.2014.00039

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