未經職業醫學專科訓練之住院醫師對疾病與職業相關性的認定：以某醫學中心1998年住院病患為基礎之研究

The Regard of Work-related Illnesses by the Residents without Occupational Medicine Training: a Study Based on Hospitalized Patints at a Medical Center in 1998

李欣玲(Hsin-Ling Lee) ； 郭浩然(How-Ran Guo)

《中華職業醫學雜誌》 8卷4期 (2001/10) Pp. 171-176

摘要

目標：本研究嘗試透過醫院住院病患之出院病歷摘要來了解目前執行病患照顧的住院醫師，在未經職業醫學專科訓練下，對疾病與職業相關性認定的情況。方法：研究對象為1998年1月至12月間某醫學中心住院的所有病患。利用住院醫師所完成之出院病歷摘要中第12欄「本次住院屬(1)職業傷害(2)職業疾病(3)與職業無關(4)不能確定」的填寫情況做為調查依據。結果：分析顯示1998年一年間共計17808名住院病患(小兒科及產科病患除外)，在17808份出院病歷摘要中有填寫職業相關與否者共726份(4.1%)，其中以內科醫師填寫最多(77.4%)。若以不同科別之住院人數來看，填寫率最高者為復健科醫師(9/27，12.5%)，其次為內科醫師(562/5566，10.1%)。於726份之填寫記錄中歸屬職業傷害者有10(1.4%)份，不確定為職業疾病者則高達350(48.2%)份。結論：本研究可看出，醫院內一般住院醫師(非經職業醫學專科訓練)對疾病與職業相關性的認定有其困難度，且做認定意願不高。因此，加強訓練及教育一線工作醫師將職業相關因素列入疾病之鑑別診斷，將有助於職業病診斷、治療及防治工作的推展，也應是今後職業醫學教育訓練工作的重點之一。

關鍵字

職業傷害 ； 職業相關疾病 ； 住院醫師

並列摘要

Objectives: Using the discharge summaries of hospitalized patients, we studied the regard of work-related illnesses by residents without occupational medicine training at a medical center. Methods: All the discharge summaries of hospitalized patients, except pediatric and obstetrical patients, from January 1998 to December 1998 at a medical center were reviewed. The number recorded in the 12th item of the discharge summary (This hospitalization was for (1)work-related injuries, (2)work-related diseases, (3)non- -work-related illnesses, and (4)illnesses with undetermined work-relatedness) was used to do data analysis. Results: Among 17808discharge summaries of hospitalized patients, only 726(4.1%) had notes in the 12th item, and most of them(77.4%) were made by internal medicine doctors. When the differences in the number of hospitalized patients in each department were taken into account, rehabilitation doctors had the highest rate of making the notes(9/72, 12.5%), followed by internal medicine doctors(562/5566, 0.1%). Among 726 discharge summaries, only 10(1.4%) were recorded as work-related injuries and up to 350(48.2%) were recorded as illness with undetermined work-relatedness. Conclusions: The results of this study indicated the difficulties in regarding the illness of occupational diseases and the unwillingness of making such determinations by physicians without occupational medicine training. Therefore, offering the specialized training and clinical education to the physicians in general will help a lot in the diagnosis, treatment, and prevention of occupational diseases. It also would be one of the key points in promoting the education of occupational medicine.

並列關鍵字

Work-related Injuries ； Work-related Illnesses ； Residents