老年群體急診醫療利用與非計劃性返診之探討

Emergency Medical Service Utilization and Non-plan Revisiting of Elderly People

黃耀緯(Si-Wen Yu) ； 游斯雯(Yao-Wei Huang) ； 簡戊鑑(Wu-Chien Chien)

《臺灣老人保健學刊》 6卷2期 (2010/12) Pp. 158-167

https://doi.org/10.29797/TJGHR.201012.0003

摘要

前言：老年群體因身體機能退化，因此使用急診醫療資源的次數較為頻繁，非計劃性急診返診的情況也較為嚴重。目的：本文以文獻回顧方式，對國內外老年群體的「急診醫療利用」及「非計劃性急診返診」進行探討。方法：將搜尋文獻區分成「老年群體急診醫療利用」及「非計劃性急診返診」兩大類別，以相互交叉回顧方式進行文獻探討。結果：在病患生理機能方面，老年群體因身體機能退化及認知功能下降，且擁有諸多共伴疾病導致病患常至急診就醫，非計劃性返診情形亦較為頻繁；在精神狀態方面，老年群體常因年事已高，生活孤獨及缺乏社會支持，且患有諸多疾病，因此常有憂鬱抑鬱的情況，亦為返診原因之一；此外，老年群體至急診就醫時，常會產生暫時性的譫望，醫療服務人員應審慎視之。結論：醫療為連續性的服務，醫療體系應做好中、長期照護規劃，並與社區結合，落實家庭醫師制度，促使老年群體能獲得安全性、適切性、可近性、連續性及完整性的全人醫療照護。

關鍵字

老年人 ； 急診 ； 返診 ； 醫療利用 ； 品質

並列摘要

Background: The degeneration of physical function of elderly people caused the high-frequency use of emergency care and non-plan revisit emergency by the patients become serious gradually. The impact of health care system results from speedy aging on demographic structure. Aims: This article is based on paper reviewing on journals, discussing both domestic and overseas aged group using emergency medical service and non-plan emergency revisiting. To analysis factors (relevantly factors) of elderly people use emergency medical service and revisiting by non-plan emergency patients. Methods: All data are distinguished into two main parts: the utilization of elderly people on emergency medical service and non-plan emergency revisiting. Cross reviewing methods are taken in this research. Results and conclusion: On the aspect of physiological function, degeneration of physical function, degradation on cognitive function and patients who also have other diseases in elderly people caused the high-frequency used on emergency resources and emergency revisiting by non-plan cases have become frequently as well. On mental aspect, living alone, lacking of society support and other accompanied diseases on elderly people often caused depression which is one of the reasons of emergency revisiting. Furthermore, medical staff should be aware of several situations such as temporary delirium may happen during the emergency treatment on elderly people and they should pay much attention on the issue of medical care continuously.

並列關鍵字

Elderly ； emergency ； revisit ； medical service utilization ； healthcare quality