醫院員工健康管理之長期追蹤調查：建立健康醫院環境之構思

Longitudinal Study on Hospital Employee Health Management: Preliminary Thinking of Healthy Hospital Environment

梁子安(Choo-Aun Neoh)

指導教授 ： 毛莉雯

高雄醫學大學/健康科學院/公共衛生學研究所碩士在職專班/碩士(2005年)

摘要

研究目的
分析十二年全醫院員工體檢資料來探討醫院的員工“健康狀況”、健康管理及做為建構一個『健康醫院環境』之基礎。

研究方法
針對某區域醫院本研究共回溯十二年全醫院員工體檢資料共6561人次人，但結果跑完12年之體檢血液檢查值之統計分析後，加上考慮了醫院經營早期、擴建期、穩定期、檢驗科人員，設備更新等後本研究決定只使用1998-2004年之體檢血液檢查值資料。最後依資料檔中收錄於本研究之個案人次共5282人次人進行回溯性的研究，使用SAS 版8.2統計軟體分析。

研究結果
本研究之個案年齡層較低，20到39歲組就佔了80.5%。從1998到2004，員工體檢在三高 (膽固醇、三酸甘油脂、血糖)及BMI之平均值都是一年比一年高。環境衛生組、病理科組、洗腎室組、心臟科組及醫師組之健康狀況比其他組差！

討論與建議:
如果以三高及BMI當員工之健康指標，員工之健康狀況一年比一年差！各部門間應整合建構一個『健康醫院環境』以提升員工健康狀況，但員工健檢資料記錄品質需要先加強，並把資料變成更有用的員工健康管理工具。醫院缺乏員工健康狀況變化時對財務損失及成本的影響。應對環境衛生組、病理科、洗腎室及醫師工作環境深入研究以便改善他們的健康狀況。推估台灣各醫院對其員工健康現況所知不多，建議醫院評鑑也應增加『健康醫院環境』等級和『醫院員工健康狀況』的評估。應要求年度『醫院員工健康狀況』報告或季報。洗腎室除了血液污染，應再研究是否有其他物質危害人體。應呈現五年累積的員工個人“健康變化趨勢”以取代每次只有一份“當次”的健檢報告以便能“比早期更早”發現疾病。把醫院當作一個特別“社區”並建立員工健康狀況的監測系統。原住民員工醫療知識比一般原住民豐富，醫療可近性高又方便但健康狀況卻比非原住民差，也許營造原住民部落公共衛生政策應該改變。如何加強改善健康狀況的毅力和恆心也許比只有宣導醫療健康方面的知識重要。

關鍵字

醫院管理 ； 職業暴露 ； 健康體檢 ； 健康

並列摘要

OBJECTIVES:
The purpose of this study was to understand a regional hospital worker long term “health status” by retrograde analysis of 12 years worker health data to understand whether there is a need for promoting a “Healthy Hospital Environment”.
METHODS:
We retrospectively and longitudinal studied 12 years secondary worker health data of Pingtung Christian Hospital from 1992 till 2004.But due to earlier data were not so unique when document them and with more missing data, we decided to use only data from year1998 till 2004,with 5282 cases. Statistical analysis with SAS
RESULTS:
Baseline clinical characteristics showed that 80.5% of the workers were 20 to 39 years old. From 1998 to 2004, the mean value of the workers’ cholesterol, triglyceride, sugar and BMI were increasing almost annually. The environment maintaining group, pathologic group, haemodialysis group, cardiology group and physician group’s “health status” were worse than other groups.
CONCLUSIONS:
Use cholesterol, triglyceride, sugar and BMI as indicators for healthy “Health Status”, the worker health status were deteriorating annually. Although the workers were young, 80.5% of the workers were less than 40 years old, yet their health is not in best condition. Deteriorating haematolgic test results also lead us to suspect that the pathological department, dialysis department, environment maintaining worker and radiation department may be at risk of different toxic exposure .The result indicated that the hospital environment may be not healthy for worker. Thus there is a need to integrate different departments that were related to worker health to build a more “Healthy Hospital Environment” in order to improve the worker health status. But the quality of recording of health test data must be improved before these data can be turn into more useful worker health management tool. The hospital lack data concerning how much financial loss were associated with worker health status changed so far. More studies should be carried out on environment maintaining group, pathologic group, dialysis group and doctor group to improve their “health status”. Most hospital CEO in Taiwan did not understand their worker health status. We suggest that “Healthy Hospital Environment” level and “Hospital Worker Health Status” should include in hospital grading evaluation. Yearly “Hospital Worker Health Status Report” is beneficial for monitoring hospital worker health status. Beside blood contamination, other possible toxic exposure such as ethylene oxide should be search for in dialysis room. 5 consecutive years health status “trend” report should be presented to worker instead of just a single blood test data. The “trend” is helpful to achieve the aim of earlier detection than early detection. Treat the hospital as a “Special Community” and set up a worker health status monitoring system. Aborigine workers medical knowledge is better than other aborigine not working in the hospital. Medical accessibility is also very convenient to them, but aborigine worker health status was still worse than non-aborigine worker. Program to strengthen doctor and aborigine will and determination to improve their own health is more important than just medical health knowledge promotion since they already are good at it.

並列關鍵字

Health Checkup ； Hospital Management ； Health ； Occupational Exposure

參考文獻

參考文獻

英文部份

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