登革熱病人對於急診室滯留時間之探討

研究背景與目的：急診壅塞為全球性醫療體系的重要議題，過去文獻發現流行性感冒疫情會讓急診壅塞，但登革熱對急診衝擊較少有探討。本研究目的要探討登革熱疫期對急診病人流量衝擊及登革熱病人對急診滯留時間的影響。研究方法：研究個案為南部某醫學中心，採取次級資料庫分析，回溯收集2010到 2016年在急診診斷為登革熱病人，進行敘述性及推論性之統計分析。研究結果：本研究樣本數為2559筆。登革熱的病人急診滯留時間較長與非登革熱來比較，有達到統計上顯著的差異；登革熱通報人數與急診就醫總人數有正相關；不同因素病人中，急診醫學科病人滯留時間比小兒科長、年齡越大病人滯留時間越長、健保榮民身份病人急診滯留時間較長、檢傷級數越高病人滯留時間較長、需住院的病人滯留時間較出院病人長，上述因素都有達到統計上差異；只有不同性別、不同入院年份病人滯留時間沒有顯著差異，但年份若分成快篩試劑檢驗使用前後比較，使用快篩後滯留時間較縮短，且有達到統計上顯著差異。研究結論：根據統計檢定結果，登革熱疫情爆發時，登革熱病人於急診的滯留時間延長，且登革熱疫情也會衝擊到急診的就醫總人數。未來建議衛生主管機關必須針對未來可能發生的登革熱疫情來事先因應，可從三個登革熱關鍵點努力，如登革熱快篩試劑檢驗、診斷登革熱陽性後的觀察追蹤及需要住院登革熱病人的分流，希望透過這些對策，減少民眾不必要的醫學中心就醫，來減少傳染病疫情時急診滯留時間增加及急診過度壅塞。

關鍵字

急診壅塞；急診滯留時間；登革熱

並列摘要

Background and purpose：emergency department crowding are important issues in hospitals worldwide. In the past, most of the literatures discussed the impact of influenza, few literatures discussed the impact of dengue fever on emergency department crowding. Based on the background and motivation, the study investigated the impact of dengue fever on the emergency department length of stay. Materials and methods: This retrospective study used secondary data to study the patients with dengue fever in the emergency department of Kaohsiung Veterans General Hospital from 2010 to 2016. The data used the SPSS software for statistical analysis. Results:The number of samples in this study were 2559 cases. There was statistically significant difference in the emergency department length of stay between patients of dengue fever and non-dengue fever. There was a positive correlation between the number of dengue fever in Taiwan and the number of dengue fever in the emergency department of Kaohsiung Veterans General Hospital. There was statistically significant difference in the emergency department length of stay between different factors, except different sex and years. But there was statistically significant difference in the emergency department length of stay if we compared the time before and after the use of dengue rapid test. Conclusions: According to the results, emergency department length of stay will increase in the dengue epidemic and impact the number of emergency department patients. In the future, the government departments must prevent the event, from dengue rapid test screening, the observation of patients with dengue fever and the diversion of patients who need admission, reduce the unnecessary visit of medical center to reduce emergency department length of stay and emergency department overcrowding.

並列關鍵字

emergency department crowding ； emergency department length of stay ； dengue fever

參考文獻

江旺財, 李衛華, & 廖芝倩. (2015). 台灣急診室壅塞的初探. 輔仁醫學期刊, 13(4), 223-231. doi:10.3966/181020932015121304007

何建翰, 李伊真, 陳晶瑩, & 李龍騰. (2015). 登革熱：臨床診斷、處置與防治. 台灣家庭醫學雜誌, 25(3), 174-185. doi:10.3966/168232812015092503002

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陳信偉. (2015). 登革疫苗發展現況. 秀傳醫學雜誌, 14(1&2), 70-73. doi:10.3966/156104972015061401008

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登革熱病人對於急診室滯留時間之探討

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