- 學位論文
台灣醫療人員因針扎所致之直接成本費用推估
Estimation of the Direct Cost Caused by Percutaneous Injuries in Taiwan Healthcare Workers
摘要
本研究以台灣本土針扎通報系統多年來(中文版Exposure Prevention Information Network; EPINet)累計之通報資料，以及國內針扎後後續處置(包括定期檢驗、預防性投藥及陽轉後續治療)所產生之相關費用，推估台灣因職業針扎所導致的經濟損失情形。 資料來源主要是來自網路通報為主，自2004年1月1日至2010年12月31日止，並以JUMP 5.0統計軟體進行分析。在所有參予通報的59家醫院中，醫療人員總人數為30,044人針扎通報為3,237件，總人年數為99,528.76人年。其中區域醫院占70.5%，其次為醫學中心(15.4%)、地區醫院(13.6%)與專科醫院及診所(0.5%)。因針扎事件所需花費之檢驗及投藥費用共為新台幣22,829,583元，而因針扎感染疾病之醫療人員後續治療費用為新台幣43,561,543元，平均每件針扎約耗費新台幣10,344元。依本研究之針扎發生率3.3%，可推估全台灣每年約發生7,007次針扎事件，調整低報率後，可推算台灣每年發生有感染風險的針扎事件為30,558件。故每年台灣因針扎所致之直接成本將為新台幣316,091,952元。而針扎所致之經濟衝擊除了直接成本外，尚有間接成本及難以計算的無形成本，本研究並未估算；事實上，針扎所帶來的非經濟層面的衝擊也是需要我們關心的。 後續相關研究建議加入計算工時、健康諮商及心理治療等其他間接成本之估算，使台灣針扎成本推估能更加全面化。另外，本研究並未詳細針對全台安全針具使用數目及費用進行效益分析，這也是未來研究的方向，藉由了解針扎所耗費之成本，再配合使用安全針具的成本分析，提供未來在預防針扎策略上有更確實的參考依據。
並列摘要
The purpose of this study is to estimate the direct cost caused by percutaneous injuries (PIs) in Taiwan healthcare workers. This estimation includes blood tests, post exposure prophylaxis and treatments after PIs using data reported to Chinese Exposure Prevention Information Network (EPINet). A reporting mechanism of PI was established using web-based system adopted from EPINet into Chinese version. The reported data were transformed into JUMP 5.0 for calculation of PI-related cost. A total of 59 hospitals employing 30,044 HCWs have participated Chinese EPINet, and 3,237 percutaneous injuries were reported between early 2004 and the end of 2010. The annual number of contaminated PIs was estimated to be 30,558 in Taiwan. The estimated cost of PIs was 23 million new Taiwan dollars, of which resulted from blood tests and prophylaxis following an PI. In addition, 44 million new Taiwan dollars may be used for treatment of HBV, HCV or HIV seroconvertion. Nonetheless, the indirect and intangible cost of PIs was not calculated in this study. It is therefore strongly suggested that future studies may consider to look at some other impacts, if the prevention of PIs are to be more complete.