以全民健保申報檔案格式作為災難病患資料庫系統主架構的先探性實例研究

A Pilot Case Study of Disaster Victim Database System Using National Health Insurance Claim Format AS the Main Frame

蔡哲宏(Jeffrey Tsai) ； 陳聰明(Edward Chen) ； 張勝立(Sheng-Li Chang) ； 黃銑扶(Sheng-Hu Huang) ； 李怡慶(Yi-Ching Lee) ； 林楨裕(Chen-Yue Lin) ； 石富元(Fuh-Yuan Shih)

《中華民國急診醫學會醫誌》 4卷4期 (2002/12) Pp. 152-164

摘要

背景：為利災難應變時提供資訊作有效決策，本研究嘗試利用全民健保申報檔格式作為主架構，來建立完整而統一的災難病患資料庫，並探討未來實際運作時可能面對的問題。
方法：研究人員草擬格式後再徵詢專家意見完成一個完整的災難病患資料庫，其中分為全民健保申報檔及災難病患急救資料二部份。系統流程規劃與分析後外包給軟體廠商完成「災難病患資料庫通報系統」。系統完成後進行實際演練，並收集相關問題作綜合討論。
結果：在演練其間共收集實際與模擬災難等共六個事件。納莉颱風過境期間有三家醫院收治12位病患，其中三位住院，一位住加護病房，二位接受緊急手術。受傷情形以肢體傷害最多，二位出現全身性症狀。輸入一份表單平均耗用2.9分。
結論：我們認為本研究所提出的資料庫具可操作性，方便輸入，且可提供即時的資訊。建議於擴大實施時進一步了解資訊使用者對其內容在完整性及有效性的看法。

關鍵字

災難 ； 資料庫 ； 資訊 ； 網際網路 ； 全民健保

並列摘要

Objective: To establish a comprehensive and uniform database to collect information on disaster victims, we conducted a pilot study using the claim format of the National Health Insurance (NHI) system as the framework for the database.
Methods : We defined the items for the database by consulting specialists in disaster medicine. A computer program was designed to collect the data and transmit the files via Internet. It also provided web-based information for each disaster. The integrated victim database includes the NHI claim files and the resuscitation files. The victim information program included resuscitation data entry, NHI claim file transformation and file transmission. The program was able to control the access level for different users. We invited five local hospitals to setup a network and test the system within this network.
Results : We tested the system in two real typhoons and a number of simulated disasters. Three patients were admitted to hospital and two received emergency operations among the 12 patients who had data collected during Typhoon Nari. Most injuries occurred at the extremities and two had systemic symptoms. It needed 2.9 minutes to complete the data entry for each patient.
Conclusion : We conclude that this victim information system operates successfully. Thus it is a feasible system and could be applied across the whole country. We recommend applying this system in one emergency service region initially and this should be followed by an investigation of its integrity and usefulness as measured by the opinions of its users

並列關鍵字

disaster ； database ； information ； Internet ； health insurance