臺灣燒燙傷住院傷患之流行病學

Epidemiology of Hospitalized Burn Patients in Taiwan

鍾其祥(Chi-Hsiang Chung) ； 劉淳羽(Chun-Yu Liu) ； 簡戊鑑(Wu-Chien Chien)

《北市醫學雜誌》 7卷1期 (2010/03) Pp. 53-66

https://doi.org/10.6200/TCMJ.2010.7.1.06

摘要

目的：找出燒燙傷住院死亡的高危險族群，瞭解燒燙傷住院的醫療利用情況，探討影響燒燙傷住院死亡的因子。方法：使用2007年全民健康保險資料庫，串連其中的「住院醫療費用清單明細檔(DD)」與「醫事機構基本資料檔(HOSB)」，選取ICD-9-CM中N Code為940-949的燒燙傷個案，並以統計軟體SPSS 14.0進行分析。結果：2007年臺灣地區有7,126人因燒燙傷住院（男性61.23%、女性38.77%），總醫療花費為新台幣686,193,204元，住院費用的中位數為新台幣33,744.5元。整體的住院率為每10萬人31.04，男性的住院率（每10萬人37.58）高於女性（每10萬人24.34），0-4歲的嬰幼兒住院率遠高於其他年齡層，住院率前三名的縣市為嘉義市、宜蘭縣、花蓮縣。燒燙傷住院病患中53.79%（3,833人）看整型外科、41.36%（2,947人）在醫學中心住院、平均每人有2.5個共伴傷病、50.34%的傷患沒有接受手術處置，2%（138人）住院死亡。以多變項邏輯斯回歸(Multivariate Logistic Regression)分析，結果顯示影響燒燙傷住院死亡的因子計有年齡、共伴傷病數、傷害部位、燒傷深度、蓄意性傷害、醫院層級及手術處置數，整體模式的解釋力為43.5%。結論：未來應持續推動燒燙傷防制計畫，尤其是針對住院率較高的0-4歲嬰幼兒族群。

關鍵字

燒燙傷 ； 住院流行病學 ； 全民健保資料庫

並列摘要

Objectives: The identification among burns inpatients of groups at high-risk of death, the measurement of medical service utilization by hospitalized burn patients, and the identification of factors associated with hospital mortality among patients with burn injuries. Methods: This research used the datasets ”inpatient expenditures by admissions (DD)” and ”registry for contracted medical facilities (HOSB)” from the 2007 National Health Insurance research database. Analysis involved the use of SPSS 14.0 software. We defined burn cases using the ICD-9-CM N Code 940-949. Results: There were a total of 7,126 inpatient cases involving burn injury in Taiwan during 2007 (males 61.23%, females 38.77%). The total medical expenditure on these patients was 686,193,204 NT$, with a median of medical expenditure of 33,744.5 NT$ per patient. The total inpatient rate was 31.04 per 100,000, and more males were hospitalized than females (males 37.58 per 100,000, females 24.34 per 100,000). The inpatient rate for children aged 0 through 4 years old was higher than any of the other groups. Chiayi City had the highest inpatient rate, followed by Yilan County and Hualien County. Among the hospitalized burns patients, 53.79% (3,833 people) needed to consult a plastic surgical department and 41.36% (2,947 people) were hospitalized at a medical center. Each person had an average of 2.5 other diseases or injuries and about half of the burn patients did not undergo any surgery or operation. The hospital mortality among the burn inpatients was 138 people. The factors associated with hospital mortality due to burn injury were age, the number of comorbities, the site of the burn injury, the fact that the burn was intentional, the level of the hospital, and the number of operations/treatments carried out on the patient. These factors were identified by multivariate logistic regression analysis and the results explained 43.5% of the variance in the overall model. Conclusions: In order to reduce the rate of burn mortality effectively, we should continue to promote burn prevention programs, especially among major high-risk groups such as children aged 0-4 years.

並列關鍵字

burn ； epidemiology ； hospitalized patients ； national health insurance database