臺灣2005-2007年意外跌墜住院病人之流行病學

The Epidemiology of Unintentional Falls Requiring Hospitalization in Taiwan, 2005-2007

林佳欣(Chia-Hsin Lin) ； 賴錦皇(Ching-Huang Lai) ； 鍾其祥(Chi-Hsiang Chung) ； 白璐(Lu Pai) ； 高森永(Sen-Yeong Kao) ； 簡戊鑑(Wu-Chien Chien)

《北市醫學雜誌》 7卷4期 (2010/12) Pp. 323-337

https://doi.org/10.6200/TCMJ.2010.7.4.01

摘要

目的：分析意外跌墜住院傷患之流行病學特性，並找出住院死亡的危險因子，以利日後相關單位擬定合適的防制計畫。方法：使用2005年至2007年全民健康保險資料庫，串連其中的「住院醫療費用清單明細檔(DD)」與「醫事機構基本資料檔(HOSB)」，選取ICD-9-CM中E Code為880-888的意外跌墜案例，並以統計軟體SPSS 14.0進行分析。結果：台灣地區2005年至2007年，合計有180,175人因意外跌墜住院（住院死亡1.2%），其中跌倒、墜落及未明示之跌墜各佔56.1%、24.6%及19.3%。跌倒以65歲以上老人居多，其中又以女性老人所佔比例較高(63.7%)；墜落則以25-64歲中壯年男性居多(43.7%)。性別、年齡、具重大傷病身分、接受手術或處置、察爾森合併症指數、受傷情形、住院天數及傷害類型皆是住院死亡的影響因子。結論：未來相關單位必須分別針對「老人跌倒」及「中壯年墜落」事故積極進行介入，此外，醫療院所也應多加注意傷患住院死亡危險因子，以改善傷患預後及減少住院死亡情形發生。

關鍵字

跌倒 ； 墜落 ； 住院 ； 全民健保資料庫

並列摘要

Objectives: The objectives of this study were to analyze the epidemiological features of patients hospitalized due to an unintentional fall and to examine the factors associated with hospitalized mortality. Methods: This research used the ”inpatient expenditures by admissions (DD)” and ”registry for contracted medical facilities (HOSB)” datasets from the National Health Insurance Research Database for the years 2005 to 2007. We defined unintentional fall cases as ICD-9-CM E Code 880-888 and the dataset was analyzed using SPSS 14.0 software. Results: From 2005 to 2007, there were 180,175 inpatient cases caused by an unintentional fall injury in Taiwan with a hospitalized mortality of 1.2%. Falling involving the same level was the leading cause of patient, hospitalization and accounted for 56.1% of all falls. This was followed by falls involving different levels (24.6%) and unspecified falls (19.3%). The high-risk group varied across the different types of falls. For falls involving the same level, the rate was highest for elderly female individuals over 65 at 63.7%. For falls involving different levels, males aged 25-64 years were the high-risk group. The factors associated with hospitalized mortality due to fall injuries were sex, age, having a catastrophic illness card, having surgery, having treatments, the Charlson comorbidity index of the patient, the length of hospitalization and the nature of the injury. Conclusions: It is important to promote intensive intervention efforts targeting falls in the future, especially among elderly females aged over 65 and males aged 25-64, which are high-risk groups for same level falls and different level falls, respectively. Furthermore, medical departments need to pay more attention to the risk factors associated with hospitalized mortality, which will improve outcomes by reducing the in-hospital mortality rate.

並列關鍵字

fall ； hospitalization ； National Health Insurance Database