災難發生初期醫院最適處理量

The Appropriate Hospital Treatment Capacity in the Initial Hours after a Disaster

陳維恭(Wei-Kung Chen) ； 劉文斌(Wen-Pin Liu) ； 鍾侑庭(Yu-Ting Chung) ； 莊錦銘(Chin-Min Chuang)

《中華民國急救加護醫學會雜誌》 14卷3期 (2003/09) Pp. 109-115

https://doi.org/10.30018/JECCM.200309.0003

摘要

目的：本研究在推算各醫療院所，災難發生後頭2小時醫院所能處理的最大傷患數。以作為未來災難發生時，指揮系統對醫院收治病患的參考，並能將病患做有效的分流，減少因過度集中造成救護品質下降。
方法：以專家意見及醫院問卷調查方式進行。專家意見方面，使用之統計方法包括各因子百分比重之描述性分析，所佔比例最大者即為專家心目中認為會影響各醫療院所所能夠處理傷患數的因子。利用迴歸分析檢定各變數與自估最大處理量之間的關係，以找出自估最大處理量的影響變數，並推算各醫院頭2小時的最大處理量。
結果：根據專家的意見，影響災難初期醫院最大處理量的因素，以醫師人力最為重要；而以醫療院所自估的最大量對醫師人力、急診推床數、急診面積、醫院空床數及醫院總床位數做迴歸分析，其中以醫院總床位數有顯意義(頭2小時的最大處理量=15.9+0.08×醫院病床數)。影響自估量精確度的因素是醫院的所在地。
結論：在台灣，醫院總床位數是影響醫院最大處理量的因子，災難發生初期醫院或指揮中心可利用此方法有效的分配大量病患。

關鍵字

指揮系統 ； 災難 ； 醫院處置容量

並列摘要

Purpose: The purpose of this study was to calculate the maximum appropriate hospital treatment capacity in the first 2 hours after a disaster. This information can be used by a command system to handle the rapid influx of patients into a hospital, which may otherwise decrease the quality of medical care.
Methods: Data for 50 hospitals and 30 professionals were collected by means of a quesionnaire. Factors related to hospital capacity were obtained from medical professionals. A logistic regression analysis of these related factors was used to evaluate hospitals' databases and to calculate the maximum hospital treatment capacity in the initial 2 hours after a disaster.
Results: According to the medical professionals who were interviewed, the most important factor affecting hospital treatment capacity was physician manpower. However, logistic regression analysis of hospital databases showed that the key factor affecting capacity was the number of hospital beds (the maximum hospital treatment capacity in the initial 2 hours=15.9+0.08×hospital beds). The accuracy of a hospitals self-evaluation of its maximum hospital capacity was significantly related to the hospital's location rather than to the hospital level.
Conclusions: In Taiwan, the main factor affecting the maximum hospital treatment capacity was the number of hospital beds, but the capacity differed from those previously reported. A command system can use this model to more efficiently handle the influx of patients after a disaster.

並列關鍵字

command system ； disaster ； hospital treatment capacity