非緊急急診病人特性及其相關因素探討

Non-urgent Emergency Department Use by Patients in a Regional Hospital

梁亞文(Yia-Wun Liang) ； 蔡哲宏(Jeffrey Che-Hung Tsai) ； 陳文意(Wen-Yi Chen)

《台灣公共衛生雜誌》 30卷5期 (2011/10) Pp. 505-516

https://doi.org/10.6288/TJPH2011-30-05-10

摘要

目標：本研究以加拿大檢傷分類系統(CTAS)探討非緊急急診比率並探討其影響因子。方法：本研究以中台灣某區域教學醫院急診病人為研究對象，共完成840位急診病人的訪視及病歷相關資料的檢視，最後完整收集758位急診病人資料，作為統計分析之用。本研究將CTAS第四級第五級病人定義為本研究之非緊急急診病人，再以邏輯斯複迴歸計算非緊急急診發生因子的危險對比值與95%信賴區間。結果：非緊急急診比率達51.97%，就診日、急診病人認為病情是否需要急診、檢傷人員判定病人疼痛程度及病人期望多快接受看診是非緊急急診發生的顯著因子。結論：衛生主管機關應持續加強民眾對急診的認識，積極宣導急診的正確使用時機，減少急診醫療資源的浪費；推動各項醫療服務改革政策時，必須跳脫單一醫療服務的思維，鼓勵不同層級醫療照護體系的合作，保障民眾的就醫可近性與醫療服務的適當性與品質。

關鍵字

急診 ； 非緊急急診 ； 病人特性 ； 加拿大檢傷分類系統

並列摘要

This study determined the percentage of non-urgent emergency department (ED) patients and the factors influencing their visits by using the Canadian Triage and Acuity Scale (CTAS). Methods: During the study period, 840 patients presenting at a central Taiwan regional hospital ED were seen by the triage nurses and classified according to the CTAS. Data from 758 patients were analyzed. Non-urgent patients were defined as those who were classified CTAS IV and V. Multivariate logistic regression analysis was performed to identify factors associated with non-urgent ED visits. Results: Of these 758 visits, an estimated 51.97% were non-urgent. Significant factors associated with non-urgent ED patients were: visit days, patients perceptions about the emergency nature of the visit, pain level assigned by the triage nurses, and patient expected waiting time to be seen by a physician. Conclusions: Health administrators should persist in trying to educate people as to how to use ED services properly. In addition, policy makers need to understand that there is an inter-categorical relationship between ED use and other medical services; therefore, development of an integrated delivery system is encouraged along with implementation of policies to improve access to comprehensive, high quality health care services.

並列關鍵字

emergency department ； non-urgent emergency department visits ； patient characteristics ； Canadian Triage and Acuity Scale

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