臺北市事故傷害死亡率分析與監測體系之建構

Fatal Accidental Injuries in Taipei: Trend and Design of a Surveillance System

楊慎絢(Sun-Shen Yang) ； 唐高駿(Gau-Jun Tang) ； 陳美如(Mei-Ju Chen) ； 廖峰偉(Feng-Wei Liau)

《北市醫學雜誌》 5卷1期 (2008/02) Pp. 152-162

https://doi.org/10.6200/TCMJ.2008.5.1.17

摘要

目的：分析台北市1992-2006年事故傷害死亡之類型與趨勢，提出事故傷害監測與防制模式。方法：引用行政院內政部編印之衛生統計(1992-2006)，以及台北市政府主計處出版之統計年報，針對台北市居民事故傷害死亡（國際基本死因分類E47-E53），進行年代別、性別，及年齡別死亡率之分析，並以階層集群分析(hierarchical cluster analysis)比較1992年～2005年臺北市各行政區事故傷害死亡率之差異程度與分類。結果：台北市住民之事故傷害死亡率，從1992年的每十萬人口35.1至2006年的14.4，大致呈現逐年下降的趨勢；1992年事故傷害為死亡的第四大原因，2006年則降為第八大死因。以事故傷害死亡之原因分析，除1999年發生地震災害之外，歷年均以運輸事故為首要原因；以性別區分，男性均多於女性，且集中在中壯年族群，並以運輸事故為首要原因。隨著年齡增加，事故傷害死亡率亦逐步上昇；且在65歲以上的長者，意外墜落的死亡率漸漸接近運輸事故的死亡率。階層集群分析結果顯 示大安、中正、信義、內湖、士林區的事故傷害死亡率相似較低；萬華、南港區相對較高。若不包括1999年的地震災害，松山區的事故傷害死亡率則與大安、中正、信義等區相近。結論：比較台北市各區事故傷害死亡率後發現，有相對高低的兩群，然而，各區事故傷害死亡率，不一定代表當地社區的安全狀況。針對台北市全力推動的健康城市與安全社區，目前亟需建立周全的事故傷害監測體制，分析事故傷害者的年齡、性別、意圖，以及事故機轉，並提出改善策略。另一方面，亦須評估事故傷害的殘障程度、健康相關生活品質，依傷害失能等級，提供復健治療與社福資源。進而評估健康人日與經濟成本損失，推估事故傷害造成的疾病負擔，並評估安全社區介入計畫之成效。

關鍵字

安全社區 ； 事故傷害 ； 階層集群分析 ； 監測體制

並列摘要

Background and Purpose: To analyze the type and trends of fatal accidental injury in Taipei from 1992 to 2006, and design an injury surveillance system and prevention mode. Methods: According to government health statistics (1992-2006), the database of fatal accidental injuries (E47-E53) in Taipei was analyzed, and the accidental injury mortality rates for the 12 districts of Taipei City was compared using the method of hierarchical cluster analysis to reveal the classifications and differences between the districts. Results: The trend in the accidental injury mortality rate in Taipei has declined in the last 15 years, from 35.1 per 100,000 persons (1992) to 14.4 (2006), and has dropped from being the 4th leading cause of death (1992) to the 8th (2006). Accidental injury mortality cases were prominent in the male, middle-aged group, and transportation accidents (E47) were the leading cause of death, apart from the earthquake in 1999. The accidental injury mortality rates increased with age, and the importance of accidental falls (E50) was close to that of transport accidents among the elderly. Using hierarchical cluster analysis, the accidental injury mortality rates (1992-2006) in the Da-An, Zhongzheng, Xinyi, Neihu, and Shilin districts were classified into the low rate group, compared to high rate group in the Wanhua and Nangang districts. Excluding the earthquake in 1999, the accidental injury mortality rate in the Songshan district was close to that in the Da-An, ZhongZheng, and Xinyi districts. Conclusion: Comparing the accidental injury mortality rates in the 12 districts of Taipei City revealed two different groups, but the accidental injury mortality rate by itself cannot truly represent safety in the districts. With the aim of promoting a healthy city and a safe community in Taipei, it is necessary to develop an accidental injury surveillance system to analyze the characteristics of the accidents, and implement reforms. Health-related quality of life and disability must be evaluated for the injured victims to provide a rehabilitation program and social resources. According to the economic and health outcomes, the disease burden of accidental injury and the effectiveness of safe community intervention should be assessed.

並列關鍵字

safe community ； accidental injury ； hierarchical cluster analysis ； surveillance systemShe even expressed a desire of returning to work and to care for patients