動機:回顧過去新北市緊急救護服務系統 (Emergency Medical Services System, EMSS) 之相關研究,並未針對高級救護服務 ( Advanced Life Support , ALS ) 的需求進行評估。 目的:本研究主要目的為針對新北市高級救護服務之需求案件進行評估。 方法:對新北市2010及2011年的救護紀錄表,進行回溯性研究法 (retrospective study) ,研究回顧所有ALS需求的要件 (包含:救護紀錄表上患者主訴、生命跡象、使用急重症之急救處置與求救原因) ,以決定病患是否符合ALS派遣標準,並用百分比表示ALS需求案件比例。利用卡方分配檢定 (Chi-square test) ALS需求案件,與季度、週間/週末、時段以及反應時間是否有顯著的相關性。 結果:新北市共29個中隊,兩年間ALS需求案件皆與年度有顯著相關的中隊共19個,與季度有顯著相關性的中隊有18個,與時段 (兩小時劃分) 有顯著相關性的中隊有2個。ALS需求案件與週間/週末共25個中隊無顯著相關性,與反應時間有20個中隊無顯著相關性。 結論:新北市ALS需求案件比例與成長率都比台北市高,且由新北市反應時間檢定結果推測,新北市兩年間有20個中隊無論需求案件等級可能皆提供相同的服務,雖然本研究與過去研究篩選準則、抽樣方法不同以及新北市官方原始資料的不完整導致本研究統計數據偏離實際情形,但本研究依然建議新北市以ALS需求案件之特徵規劃、執行救護雙軌制。
Motive: Previous studies on Emergency Medical Service System did not show the evaluation on Demand for Advanced Life Support in New Taipei City. Objectives: To evaluate Demand for Advanced Life Support in New Taipei City. Methods: A retrospective analysis of the EMS records of New Taipei City Fire Department from January 2010 to December 2011 was conducted. Retrospective ALS demand criteria, including the chief complaints, mechanisms of injury/illness, initial vital signs and types of rendered.Using the Chi-square test to check whether there are sufficient evidence indicate that ALS demand is independent of quarters、weekdays/weekend、hours and Response Time per unit. Results:There are 29 units in New Taipei City. 19 uints have sufficient evidence indicate that ALS demand is dependent of years, 18 uints have sufficient evidence indicate that ALS demand is dependent of quarters, and 2 uints have sufficient evidence indicate that ALS demand is dependent of hours.There are 25 uints which have sufficient evidence indicate that ALS demand is independent of weekdays/weekend, and 20 uints have sufficient evidence indicate that ALS demand is independent of Response Time. Conclusion:Either the ratio or the growth rate of ALS demand is higher than those of Taipei City. Also, the test result of Response Time suggests that there might be 20 units providing the same service despite case levels. Somehow, there might be slighty mismatch due to the difference of screening criteria, sampling methods and incomplete data compared to those previous studies. However, we still suggest to conducted Two-tiered EMS System in New Taipei City.