急診因酒精受傷患者的特性及酒精篩檢的問題討論

Characteristics of Alcohol-Related Trauma Patients and Discussions of Alcohol Screening in Emergency Department

張啟宏(Chi-Houng Chang) ； 黃睦舜(Mu-Shun Huang) ； 高偉峰(Wei-Fong Kao)

《Journal of Emergency Medicine, Taiwan》 11卷4_S期 (2009/12) Pp. s7-s13

摘要

Purpose: The objective was to estimate the prevalence of alcohol use in trauma patients admitted to emergency department and the consequential impact on medical expenditure.
Materials and Methods: We reviewed the trauma patients admitted to the Emergency Department of our hospital during 2007 and collected data from patients whose blood alcohol concentrations were measured on admission. The data collected for analysis included basic bio-information, trauma mechanism, injury areas, ISS, blood alcohol concentration and claimed insurance payment point.
Results: Among 16,085 trauma patients admitted to our ED during 2007, 1,738 cases (10.8%) were tested for blood alcohol concentration with 652 cases (4.1%) found positive. Among the positive cases, 554 cases (85.0%) were male, 428 (65.6%) caused by traffic accident, 386 with head injury, and 53 with ISS ≥16. 329 (50.5%) out of the positive cases were hospitalized and 9 patients died. The averaged total payment points claimed for health insurance payment point by the positive patients were 6394 points, significantly higher than the average claim of 2515 by the rest of the enrolled patients (p＜0.01).
Conclusion: Because that the actual number of alcohol-related trauma injuries is most likely underestimated and that the cost for subsequent medical treatment is substantially higher than that for other trauma patients, a standard procedure to increase the percentage of patients receiving alcohol screening on admission should be implemented in an emergency department. The preventive measurements should effectively reduce alcohol-related injuries and the cost of medical treatment.

關鍵字

酒精 ； 篩檢 ； 受傷 ； 健保

並列摘要

Purpose: The objective was to estimate the prevalence of alcohol use in trauma patients admitted to emergency department and the consequential impact on medical expenditure.
Materials and Methods: We reviewed the trauma patients admitted to the Emergency Department of our hospital during 2007 and collected data from patients whose blood alcohol concentrations were measured on admission. The data collected for analysis included basic bio-information, trauma mechanism, injury areas, ISS, blood alcohol concentration and claimed insurance payment point.
Results: Among 16,085 trauma patients admitted to our ED during 2007, 1,738 cases (10.8%) were tested for blood alcohol concentration with 652 cases (4.1%) found positive. Among the positive cases, 554 cases (85.0%) were male, 428 (65.6%) caused by traffic accident, 386 with head injury, and 53 with ISS ≥16. 329 (50.5%) out of the positive cases were hospitalized and 9 patients died. The averaged total payment points claimed for health insurance payment point by the positive patients were 6394 points, significantly higher than the average claim of 2515 by the rest of the enrolled patients (p＜0.01).
Conclusion: Because that the actual number of alcohol-related trauma injuries is most likely underestimated and that the cost for subsequent medical treatment is substantially higher than that for other trauma patients, a standard procedure to increase the percentage of patients receiving alcohol screening on admission should be implemented in an emergency department. The preventive measurements should effectively reduce alcohol-related injuries and the cost of medical treatment.

並列關鍵字

alcohol ； screening ； injury ； health insurance