年齡、收入及傷害類型是老人受虐住院的預測因子

Age, Income and Pattern of Injury are Predictors of Elderly who are Hospitalized due to Abuse

鄭倩樺(Chien-Hua Cheng) ； 鍾其祥(Chi-Hsiang Chung) ； 楊雅婷(Ya-Ting Yang) ； 簡戊鑑(Wu-Chien Chien)

《北市醫學雜誌》 9卷4期 (2012/12) Pp. 374-387

https://doi.org/10.6200/TCMJ.2012.9.4.07

摘要

目的：分析65歲以上受虐及非受虐老人傷害類型及醫療利用之差異，找出老人受虐的預測因子。方法：使用1997-2009年全民健保資料，選取老人受虐傷害住院個案（995.8x與E967.x）及非受虐傷害住院個案（E800-E949），進行分析比較。結果：受虐老人為低收入戶的比例是非受虐者的2.75倍；傷害數≧2處的比例是非受虐者的2.31倍；傷害類型在顱內損傷、頭部/軀幹/上肢開放性傷口、創傷性併發症與損傷、挫傷、表淺損傷均顯著高於非受虐老人，但在下肢骨折、醫療費用及住院天數皆低於非受虐老人。在控制了傷害數、醫療費用及住院天數後，老人受虐住院的預測因子為年齡、低收入戶及傷害類型。結論：年輕老人、低收入戶與傷害類型是老人受虐傷害住院的預測因子，臨床醫療人員可用以辨識傷害住院老人是否遭受虐待，並進行後續處置。

關鍵字

老人虐待 ； 傷害 ； 全民健保資料庫

並列摘要

Objectives: To compare the injury patterns and medical utilization of individuals who are more than 65 years of age and who are victims of abuse to similar data from non-abuse patients in order to identify predictors of abuse of the elderly. Methods: This research correlated ”inpatient expenditures by admissions” and ”registry for contracted medical facilities” from National Health Insurance research database for the years 1997-2009. We defined abuse of the elderly cases as ICD-9-CM N-code 995.5x and E-code E967.x and the controls as ICD-9-CM N-code E800-E949. Results: The proportion of cases among low-income households was 2.75 times higher than among the control individuals. Individuals involved in coded abuse who had more than two injury sites were 2.31 times more frequent than control individuals who had more than two injury sites. The presence of an intracranial injury, an open wound of the head, an open wound of the trunk, an open wound of an upper limb, traumatic complications, unspecified injuries, contusions and superficial injuries were also significantly higher among elderly individuals who had suffered coded abuse. The main predictors of abuse among the elderly were age, income level and specific patterns of injury. Conclusions: This study highlights that several factors are able to detect elderly victims of abuse when they undertake a medical visit. These factors can be used by medical professionals to detect abusive victims in order to protect these elderly persons from additional abuse.

並列關鍵字

abuse of the elderly ； injury ； National Health Insurance research database