急診病人輕症就醫分析：以某區域教學醫院為例

全民健康保險自1995年實施以來已經走過24個年頭，自開辦之初的1996年健保費用約2229億元，短短20多年間，整體費用已增加數倍。台灣的急診因其便利性、快速性以及普遍性，因此也造成了全台各大醫院急診幾乎都是人滿為患的狀況。而急診過度壅塞亦可能導致候診時間延長以及死亡率增加之危險。本研究試以桃園某區域教學醫院為例，探討其急診經檢傷分類收治病人之疾病類型、收治人數、醫療費用耗用等相關數據，藉以了解輕症病人在急診收治病人中占比為何，並希望能透過數據分析呈現出急診收治病人情形的大致輪廓，以了解輕症佔比對醫院的影響，預計探討的幾大面向如下：1、重大疾病佔急診就醫比例、2、非屬於重大疾病的病患佔急診就醫比例3、急診醫療耗用情形4、特殊收治族群分析。研究結果顯示，收治病人屬於健保署規範的重大傷病的佔比約為24.69％，而非屬於重大傷病的比例則為75.31％，從數據我們可以看出，該院在收治急診病人數方面重症與輕症的收治比幾乎是1：3，可看出該院急診的確存在著輕症收治比例較高的問題，且急診的藥衛材及醫療健保點值耗用上，確實也造成了醫療資源的不當消耗。透過此研究，希望凸顯當初健保設定分級醫療的重要性，並喚醒社會及政府對健保制度弊端的重視，期望將來我國在制度面、教育面上都能逐步落實，以能夠讓健保制度真正永續經營。

關鍵字

急診壅塞；檢傷分類；醫療資源耗用

並列摘要

The National Health Insurance has gone through 24 years since its implementation in 1995. Since its inception in 1996, the health insurance cost was about 222.9 billion yuan. In just over 20 years, the overall cost has increased several times. Because of its convenience, rapidity, and universality, the emergency department in Taiwan has caused overcrowding in emergency departments in major hospitals throughout Taiwan. Excessive congestion in the emergency department may also lead to longer waiting times and the risk of increased mortality. In this study, a regional teaching hospital in Taoyuan was used as an example to explore the relevant types of disease, number of patients, and medical cost consumption of patients undergoing emergency treatment by classification, so as to understand the proportion of mild patients in emergency treatment. And hope to present the outline of the situation of emergency patients admitted through data analysis to understand the impact of the proportion of mild on the hospital. It is expected to discuss the following aspects: 1. Major diseases account for the proportion of emergency medical treatment 2. Non-critical diseases Patients accounted for the proportion of emergency medical treatment 3, emergency medical consumption 4, analysis of special admission ethnic groups. The results of the study show that the proportion of patients with serious injuries and diseases that are regulated by the Health Insurance Agency is about 24.69%, while the proportion of patients who are not serious injuries is 75.31%. From the data, we can see that the hospital is seriously ill with the number of emergency patients admitted. The admission ratio for mild cases is almost 1:3. It can be seen that the emergency department of the hospital does have a high proportion of mild admissions, and the use of medical and health materials and medical health insurance points in the emergency department has indeed caused medical resources. Improper consumption. Through this study, I hope to highlight the importance of the health care setting tiered medical treatment, and awaken the society and the government to the shortcomings of the health care system. I hope that in the future, our society will gradually implement the system and education to make the health insurance system truly permanent. Continue to operate.