以醫療區為基礎之流感併發重症疫情監控系統

Severe complicated influenza surveillance system using health care regions as a basis

吳姿瑩(Tzu-Ying Wu) ； 張家榮(Chia-Jung Chang) ； 吳文祥(Wen-Hsiang Wu)

《醫務管理期刊》 19卷3期 (2018/09) Pp. 227-248

https://doi.org/10.6174/JHM.201809_19(3).227

摘要

目的：疾病管制署所建置流感併發重症之地理分佈圖，只考量各縣市病例數，易造成人口數多自然呈現疫情嚴重假象。方法：本研究應用傳染病疫情通報系統病例數為研究對象，先運用集群分析法將2009至2016年資料分群以做為疫情嚴重程度分級依據。以生活圈為醫療區劃分基礎再結合管制圖分析各醫療區疫情嚴重程度後，再繪製地理分佈圖以呈現疫情狀況。結果：流感雖以秋、冬較容易爆發疫情，但仍可能春夏季發生，以2017年為例疫情爆發於第17-31週而於第32週趨緩，更可發現第27週開始疫情為重度狀態，集中在雲林縣、高雄市與屏東縣。結論：流感疫苗接種為10月開始，接種2週後才產生保護力，若流感發生春夏季時就來不及使用疫苗防治。本系統可即時監控且易於解讀何地發生疫情，以及時控制疫情。

關鍵字

醫療區 ； 流感併發重症 ； 地理資訊系統 ； 管制圖

並列摘要

Objectives: To solve the seemingly serious conditions in cities with higher populations as presented by the Centers for Disease Control, with single consideration to the number of cases of severe complicated influenza in each city for geographical distribution. Methods: This research uses the number of cases in the reporting system of infectious disease outbreaks from 2009 to 2016 as research objects, utilizing cluster analysis to group data. In addition, a control chart is used to analyze the seriousness of the disease in each city as a geographic location, classified as level two health care regions, with different colors employed to show the level of severity and draw a geographical distribution of the influenza outbreak. Results: Influenza outbreaks often occur in the fall and winter seasons, but may also occur in spring or summer. Using 2017 as an example, the outbreak was weeks 17-31, which slowed down in week 32. Moreover, the outbreak became serious from week 27, mainly in Yunlin County, Kaohsiung City and Pingtung County. Conclusion: Inoculations against influenza are available in October. The vaccination will be effective two weeks after injection. Therefore, if the influenza outbreak happens in spring or summer, it will not be possible to use vaccination as means to prevent influenza. This system can monitor when and where the outbreak has occurred, and provide information for health authorities to propose appropriate policies.

並列關鍵字

health care regions ； severe complicated influenza ； geographic information systems (GIS) ； control chart

參考文獻

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