醫院持續營運系統脆弱度之探討

本研究希望藉由醫院持續營運系統脆弱度相關資料之收集與分析，建立解釋模式，供醫院因應災害整備時之參考；因此，以世界衛生組織（World Health Organization, WHO）所提出「安全醫院」內容，設計作調查表，檢視全臺各級醫院曾因天然或技術災害之衝擊資料，探討醫院因外部基礎設施功能失效導致中斷營運，以判別分析及邏輯迴歸等統計方法，探討影響醫院持續運作之因素與中斷服務所具預測力之參數。本研究結果發現，藉由蒐集醫院非結構之功能性醫療服務系統影響資料，包括電力、供水、通訊、醫療氣體、燃油、醫療資源、急診設備、應變組織等變項資料，針對醫院受災時，能否持續運作，確有預測能力；未來應蒐集更多案例，提供醫院做為持續運作減災與整備的重點。

關鍵字

持續運作；安全醫院；判別分析；邏輯迴歸

並列摘要

The ability of a hospital's services to function without interruption during a disaster is a matter of life and death. Thus, hospitals must withstand the impact of any natural, human-made or technical disasters, to the extent that medical systems are not damaged and vital interior infrastructures are maintained, and that health personnel are able to continue providing medical assistance in the event that facilities are isolated by the impact of the disaster. The focus of this paper is to investigate the continuous operations of hospitals which were mostly impacted by the 921 earthquake in 1999, the flood of Trami and Nari Typhoon in 2001 respectively. Other interruptions to operations, such as those experienced due to drought or the failure of information systems, are also examined. The data collected focuses mainly on non-structural safety aspects with the emphasis on functional capacity which extracted in accordance with the requirements of ＂Safe Hospital,＂ as proposed by the World Health Organization. Functional capacities of continuous operations in hospitals such as power supply, communications, water, fuel for generators, medical gases, medical resources, first aid equipment, and response organization were collected for analysis. Statistical methods were employed to correlate and test for significant differences between variables; to explore the explanatory parameters that would influence a hospital's continuous operation; to establish explanatory models for service interruption during or after a disaster. The study also proposes a method to estimate the impact of utility interruption in hospitals. Further research would help in building a better understanding of the correlation between, and testing for, significant differences in various medical systems based on a variety of disasters. It is anticipated this would provide the basis for future policies useful to health authorities in the improvement of hospital's continuous operation during or after disasters.

並列關鍵字

Continuous operation ； Safety hospital ； Discriminant analysis ； Logistic regression

參考文獻

中央通訊社，2014，〈高雄氣爆醫院緊急加床〉。2015 年10 月19 日，摘錄自https://tw.news.yahoo.com/%E9%AB%98%E9%9B%84%E6%B0%A3%E7%88%86-%E9%86%AB%E9%99%A2%E7%B7%8A%E6%80%A5%E5%8A%A0%E5%BA%8A-040642992.html