急診病人三日內重返急診之分析：全民健康保險研究資料庫之抽樣歸人檔資料分析

Emergency Department Revisiting by Patients over a Three-day Period in Taiwan: A Population-based Descriptive Study

葉時烊(Shih-Yang Yeh) ； 胡百敏(Pai-Min Hu) ； 廖浩欽(How-Chin Liao) ； 林作彥(Tso-Yeh Lin) ； 王少谷(Shao-Ku Wang) ； 廖訓禎(Shiumn-Jen Liaw)

《台灣急診專科醫師期刊》 2卷1期 (2010/03) Pp. 6-13

https://doi.org/10.29749/JTCEP.201003.0002

摘要

研究目的：本研究旨在了解於急診病人離開急診後三日內返診之狀況，以及返回原急診與他院急診之相關因素。
研究方法：研究資料對象為全民健康保險研究資料庫，自89年至94年六年之承保抽樣歸人檔中所有急診人次。去除年度急診就醫超過二十次者後，對急診返診進行分析。
主要發現：7.4%急診病人在急診就醫後於三日內重返急診求醫，其中28.4%為急診當日即重返急診；第二次急診就醫後有24.1%病人住院、11.3%於第二次急診後三日內第三次至急診就醫；47.5%為再至其他醫院之急診；25.9%的病人第二次急診就醫之診斷與第一次完全不同。與病人選擇再至同一急診就醫的相
關因素有年齡、返診日、第一次就醫院所評鑑等級及新的醫療問題。
結論：急診三日內總重返率為7.4%，其中有47.5%的病人重返其他醫院急診，選擇到原急診與另一急診的就醫病人屬性不同。

關鍵字

急診 ； 三日內急診重返

並列摘要

Methods: All ED visits from a systematic random sample cohort from the national health insurance (NHI) research database in Taiwan during the period between 2000 and 2005 was used in this study. Patients who visited EDs more than twenty times annually were excluded.
Results: The 3-day ED revisit rate was 7.4%, retrospectively; among the cohort, with 28.4% of the individuals revisiting the EDs within the same day. After the second visit, 24.1% of these were admitted to hospital and 11.3% visited an ED again within 3 days. In total, 47.5% of the patients visited a different ED to the first for their revisit and 25.9% of patients had different diagnoses between the first and the second visit. The relative factors associated with a same ED revisit included age, the date after the index visit, the accredited level of the index hospital, and the new medical problems.
Conclusion: The overall 3-day ED revisit rate was 7.4% and 47.5% of them visited another hospital's ED for the second visit. The group that revisited the same ED had different characteristic from the group that visited an ED of another hospital for the second visit.

並列關鍵字

emergency department ； 3-day revisit