飲酒相關交通事故之醫療花費及死亡率情況分析

Medical Cost and Mortality of Alochol-related Traffic Accidents

李燕鳴(Yin-Mig Li) ； 白璐(Lu Pai)

《台灣家庭醫學雜誌》 10卷3期 (2000/09) Pp. 148-161

https://doi.org/10.7023/TJFM.200009.0148

摘要

機動事故是花蓮縣內悄壯年之主要死亡原因，飲酒行為可能是重要因素。本文以621位因機動車故來急診傷者為研究對象，檢驗血中酒精濃度(blood alcohol concentration, BAC)、調查其人口學特性、評估受傷嚴重度，並連結醫院資料檔，調查其相關急診和住院費用、手術比例及住院夾數，再經病歷檢閱、電話訪目及2年後連結衛生署死亡資料檔調查及確定傷患之死亡率。結果發現363位(58.1%)是飲酒相關事故，平均年齡為34.0歲，67.8%是男性，58.3%是駕駛人，BAC陽性傷者之死亡率是4.1%, 平均醫療費用為21200.8元，平均住院4.1天數；傷者BAC天50-100 mg/dL 的傷者之平均醫療費用和住院天數最砲，駕駛人且BAC陽性傷者(921位)之平均醫療費用是21819.3元，住院天數平均4.2天。BAC陽性與陰性傷者間於平均醫療費用或住院天數、有頭傷及住院的比例沒達顯著差異；BAC陽性且有頭部外傷傷者之死亡率最高(10.2%)，較BAC陰性之頭部外傷傷者(1.4%)死亡率高出5.1倍；因當BAC超出50mg/dL 便明顯增加事故發生的風險，明顯酒後駕駛傷者所耗之醫療費用，個人是否應負部份責至值得進一步評估，故建議健保局設訂事故傷害需檢驗酒精濃度的規定、評做飲酒行為與事故的相關性、所耗之醫療費用，並討論責任歸屬及醫療保險支付的範疇。

並列摘要

Injury is a major cause of deaths in Hualien District. Driving under the influence of alcohol may be one of the important causes. There were 621 injured patients tested with their blood alcohol concentration (BAC). The demographic characteristics of the patients were recorded and their injury severity were assessed by nurses at the emergency department. The medical costs, the numbers of hospital days and operations on the patients were obtained through the hospital records. The mortality rate was made through chart reviewing, telephone calling and the data from the department of Health. There 363(58.1%) injured with positive BAC, mean age 34 years old, 67.8% male, and 58.3% were drivers. The mortality of 363 BAC-positive injured was 4.1%; the average medical cost for each was NT$ 21,200.8; their average hospital stay was 4.1 days. The average medical cost or hospital days were highest among injured with BAC of 50-100 mg/dL. Of the 291 drivers who were BAC-positive, the average medical cost for each was 21,819.3 and their mean hospital stay was 4.2 days. No significant differences of medical cost, hospital stay, and head injuries were found between BAC-positive and –negative. The mortality rate(10.2%) was highest among the patients with BAC-positive and head injuries. The risk of accidents was increased significantly with BAC at 50 mg/dL or above. Should they be responsible for their medical costs? We suggest that the Department of Health Insurance should set up regulation for mandatory blood alcohol testing for injured patients sustained from traffic accidents. An assessment of the association of alcohol and medical expenditure should be made. The responsibilities of drivers under alcoholic influence which caused the accidents and their Medical Insurance coverages should be discussed.

並列關鍵字

traffic accidents ； driving under the influence of alcohol ； medical cost ； mortality ； Hualien District