勞工保險門診職業災害比率及分佈之調查研究

A Study on Proportion of Occupational Illnesses and Injuries of Labor Insurance Out-patients

董和銳(Heh-Ruey Tung) ； 劉紹興(Saou-Hsing Liou) ； 石曜堂(Yaw-Tang Shih)

《中華職業醫學雜誌》 1卷3期 (1994/07) Pp. 99-109

摘要

勞工保險條例明訂：「職業災害保險之會計應單獨辦理」。目前由勞保門診診療單勾劃所區分之職業災害與普通事故並不確實，且有不少門診單未勾劃傷病種類。本研究之目的即估計勞保門診中職業災害的比率。
我們以勞保被保險人罹患傷病至勞保特約醫療院所看診人次為母群抽樣。依不同地區之勞保門診單數比例及不同規模之醫療院所按比例抽出相當之醫療院所，被抽中之醫療院所之所有勞保看診人次均為蒐集對象。自79年9月至80年4月隨機抽出14天為資料蒐集日，郵寄擬好之問卷至樣本醫療，由病患填寫。從所填之工作（行業與職業）、主訴，由五位職業醫學專家判斷是否相關，三位或三位上認為有關即判為職業災害。
結果回收有效問卷14,172張（人次），其中判為職業災害者1,614人次，職災比率11.39%。扣除農保患者，勞保門診災害比率為11.20%。
本研究之回應率（Response-rate）偏低，回收之問卷數僅佔應回收問卷數（樣本數）之13.7%。根據在馬偕醫院的觀察，未填者其不填問卷的原因應與我們調查的變項（職災情形）無關，故我們認為此一回收不足樣本仍為一隨機樣本。而在測量工具方面，雖然我們僅能從問卷所提供的有限資訊來判斷是否與工作有關，但五位職業醫學專家經驗學識豐富，且判讀結果十分一致，應有相當之準確度。

關鍵字

職業災害 ； 門診 ； 勞工保險

並列摘要

It is very important to differenciate occupational illnesses and injuries from other illness and injuries. According to the Act of Labour Insurance, there are different funding and accounting system between occupational injuries and illnesses benefit payment and other benefit payment. So far, the form of out-patient benefit payment claims has four columns (occupational illness, occupational injury, other illness and other injuries). From these columns, We may count the propotion of occupational illnesses and injuries but they are usually not correct. Therefore, the purpose of our study is to estimate the propotion of occupational illnesses and injuries of out-patient payment claims under insurance.
Our sampling population was the total out-patient benefit claims forms from contracted hospitals and clinics under Labour Insurance. We got different propotion of samples of hospitals and clinics according to different areas and different scales of hospitals. Every sampled hospitals’ and clinics’ total out-patient benefit claims consist a cluster. From Sep. 1990 to Apr. 1991, We randomly selected 14 days to mail the questionnaires to the sampled hospitals and clinics for inquiring the patients about his or her industries, occupations and chief complaints. The questionnaired were judged by five occupational medicine experts.
The valid questionnaires returned from the sampled hospitals and clinics are 14,172 pieces, of which, 1,614 pieces were judged as work-related illnesses and injuries. The propotion is 11.39%. After excluding the farmers, the propotion is 11.20%.

並列關鍵字

Occupational illnesses and injuries ； Out-patients ； Labour insurance