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  • 學位論文

急診醫療資源配置之最適化研究

Study on the optimization of emergency medical resource allocation

指導教授 : 陳秀珠
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摘要


中文摘要 近年來醫療市場環境變遷,醫院朝大型化發展,中小型醫院逐漸減少,使得整個醫療服務系統中緊急醫療救護資源出現缺口,衛生主管機關透過專案補助計畫、法令的修訂…等,希望可逐漸補強緊急醫療資源,以保障民眾緊急醫療就醫之權利。 有鑑於此,本研究希望透過對彰化縣急診醫療資源現況,及其所面臨的問題,以數量分析方法加以分析,進一步提出急診醫療資源配置最適化的建議,以供衛生主管機關參考,期使急診醫療資源投入在重要刀口上,以確保民眾及時取得急診醫療資源服務。 本研究分析結果顯示,依目前彰化縣急診醫療資源配置下,第一優先建議應提升和美鎮、北斗鎮、田中鎮之一般急救責任能力至中度急救責任醫院能力,可立即提供彰化縣26鄉鎮民眾於7.5公里內取得中度急診醫療服務;第二優先建議將員林鎮、二林鎮之現有中度急救責任醫院能力提升至重度急救責任醫院能力,以作為未來急救重症後送之據點。 另外,透過本研究實際交通位置的研究發現,醫療資源配置之責任單位,不應侷限在目前行政區域之劃分下規劃急診責任區域,應進一步考慮交通生活圈方式重先劃分,以符合實際距離之可近性。未來本研究模式,亦可擴展運用在各種有關衛生管理政策之醫療區域劃分,如中風中心、創傷中心…等各項主題之醫療資源配置運用。

並列摘要


The health care environment changes in recent years, the hospital is towards maximization development, the medium and small scale hospital reduces gradually. It generates the gap in the emergent medical resources of medical health care service system .The health bureau tried to apply the special support program, revised the laws to enforced the emergent medical resources and protect the publics’ right of receiving emergent medical services. According the above, this research used the quantitative method to analyze the present emergent medical resource in Changhua and the problem faced. We hope to find out the optimization distribution of emergent medical resources as the reference for health bureau. Therefore, the emergent medical resource may use on the most needed and ensure publics may obtain emergent medical resources in time. The results of this research reveal, under the present emergent medical resource distribution, we suggest the first priority should focus on raising the ability of 「basic level first aid duty hospitals」 to 「middle level first aid duty hospitals」 in Hemei, Beidou, Tianzhong. Thus the publics of 26 towns in Changhua may obtain middle level emergent medical services within 7.5 kilometers. The second priority is raising up the present ability of 「middle level first aid duty hospitals 」to「Heavy level first aid duty hospitals 」in Yuanlin, Erlin. Thus they can be the locations for the treatment of critical patient. Furthermore, according to the study on real traffic time for searching emergent medical services, the duty hospitals assignment should not be limited to the present executive districts, but also need to consider about the traffic net. In the future, the model of this research may also apply to limited medical resources allocation problems, such as stroke centers, trauma centers.

參考文獻


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