隨著老年人口之增加,老人之醫療照護問題日益重要。意外災害是六十五歲以上老人之第六大死因,也是老人醫療照護的重要問題之一。本研究分析自1974年至1990年問臺灣地區意外災害之死亡資料,以粗死亡率、65-84歲之累積死亡率及標凖化潛在生命損失等三種指標,作性別、年齡別、死因別與年代別之比較,並與腦血管疾病、惡性腫瘤、及心臟病之長期趨勢對照。結果發現,老人意外災害之死亡率,隨年齡之增加而升高;男多於女;以事故種類來看,男女之排行依序為:機動車交通事故、意外墜落、意外中毒及溺水、火災。各事故除溺水外,其餘在男女兩性均大致呈上升之長期趨勢。與腦血管疾病、惡性腫瘤及心臟病比較,意外災害之死亡率雖較低,但其近年來上升比例最大;惡性腫瘤在老人之死亡率亦呈上升趨勢,心臟病之變化不明顯,而腦血管疾病則逐年降低。以上結果,用前述三種死亡指標比較,所得之結論相同。
Problems in geriatric health care delivery are becoming more and more important as the elderly population of our country grows. Accident is the sixth commonest cause of death among people aged 65 and over. We analyzed mortality data of accidents in Taiwan from 1974 to 1990. Crude and cumulative mortality rates (65-84 years) and the standardized years of potential life lost (SYPLL) were calculated for comparisons between sexes, and among five major causes of accidents. The time trend of all-cause accident was also compared with those of cerebrovascular diseases (CVD), malignancies, and heart diseases (HD). The result showed a consistent trend that the older the age, the higher the mortality rate due to accidents. Males are more likely to die of any of the 5 major causes of accidents than females. The rankings of mortality rates for 5 major accidents are as follows: motor vehicle accidents, accidental falling, accidental poisoning, drowning and submersion, fire and flames. All these accidents showed an increasing secular trend in both sexes, except drowning and submersion. Although the cumulative mortality rates and SYPLL's caused by accidents during 1974-90 are generally lower than those of CVD, malignancies, and HD, the rate of increase in these two indicies caused by accidents are the highest. We conclude that appropriate preventive programs should be implemented for such accidents among elderly in the future.