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題 名 | 東部某醫學中心急診之人口學及品質檢討=Demographics and Quality Assurance in an Emergency Department in a Medical Center in Eastern Taiwan |
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作 者 | 胡勝川; 顏鴻章; 高偉峰; | 書刊名 | 慈濟醫學 |
卷 期 | 13:4 2001.12[民90.12] |
頁 次 | 頁223-229 |
分類號 | 419.52 |
關鍵詞 | 人口學; 急診室; 品質保證; Demography; Emergency department; Quality assurance; |
語 文 | 中文(Chinese) |
中文摘要 | 摘要 目的:東部地區原住民較多,其生活習性、喝酒的文化等影響到就醫的行為及流 行病學的分佈,為瞭解東部地區急診病人的特性,及唯一醫學中心的急診品質, 故做此研究。病人與方法:本研究統計自88年7月至89年6月期間內,來到東 部某急診室之急診病人的人口學及品質檢討;並且比較升醫學中心前後半年的轉 院人數比率、各檢傷等級比率、119送來的比率、急診住院病人的比率,以明瞭 是否有較多嚴重的病患。結果:研究期間內,共收集51,618例急診病人,因急 診而住院的病人佔來診病人的19.0%,其中以非創傷科最多 (23.0%)、創傷科次 之 (19.8%)、小兒科最少 (7.9%) (p < 0.001);老年 (> 64歲) 病患中,非創傷科 比創傷科比例高 (25.8% Vs 10.9%,p < 0.001);119送來的人數只佔4.9%;自他 院轉來的病人佔3.8%;以推床進來的病人佔12.7%。檢傷第1級的病人以非創 傷科最多 (6.5%)、小兒科最少 (3.1%,p < 0.001)。須住院而無法住院的比率為 3.3%,須住加護病房的比率為2.9%,只有0.1%是暫時無床而須等住加護病床者。 成為醫學中心後,他院轉入病人 (4.1% Vs 3.2%,p < 0.001)、急診住院的病人 (19.6% Vs 9.5%,p < 0.001)、119送來的病人 (5.6% Vs 3.8%,p < 0 .001)、推床 的病人 (13.4% Vs 10.1%,p < 0.001)、及檢傷分類第1、2級的病人 (7.2% Vs 5.9%;67.2% Vs 56.7%,p < 0.001) 之增加,是支持嚴重病患顯著增加的最佳佐 證。平均等看診時間為8分鐘左右,平均等檢驗報告回來的時間則為40分鐘至 110分鐘。結論:1. 就各科所佔比率而言,與西部地區的醫學中心相較,其特徵 頗為一致;唯東部地區的老年人佔急診病人的比率,比西部地區為低;但是否嚴 重的病人較多,則有待進一步的研究;2. 就等住院的人數、等候看診的時間、 及等檢驗報告回來的時間而言,與西部地區醫學中心相較,急診的品質還算不 錯,但仍有很大改進的空間;3. 自升格為醫學中心後,嚴重病患明顯增加。 (慈 濟醫學 2001; 13:223-229) |
英文摘要 | Objective: To understand the demographics of emergency patients (EPs) in eastern Taiwan, as well as the quality of the emergency department (ED) of the only medical center in eastern Taiwan. Patients and Methods: We conducted a retrospective study from July 1999 through June 2000 using analysis of data retrieved from the newly developed medical computer system. Results: During the study period, 19.0% of 51,618 EPs were admitted to the hospital. Most (23.0%) of those admitted patients were from the nontrauma section, followed by those from trauma section (19.8%) and pediatrics (7.9%). More elderly was found in the nontrauma section than in trauma section (25.8% Vs 10.9%, p< 0.001). Of these, 4.9% patients were sent by the 119 service. Transferred patients accounted for 3.8%. Non-ambulatory patients were estimated to be 12.7% of all. The Nontrauma section had the most patients in triage category 1, and the pediatric section had the fewest (6.5% Vs 3.1%). Patients who needed hospitalization but could not be admitted because of bed unavailability accounted for 3.3% of EPs. Of the 2.9% of patients who needed intensive care, only 0.1% could not be accomodated. The percentages of transferred patients, patients admitted through the ED, patients sent by the 119 service, non-ambulatory patients and triage category 1 and 2 patients significantly increased after the hospital was upgraded to a medical center compared to the period before (4.1% Vs 3.2%; 19.6% Vs 9.5%; 5.6% Vs 3.8%; 13.4% Vs 10.1%; 7.2% Vs 5.9% and 67.2% Vs 56.7%, p< 0.001, respectively). Conclusions: We conclude that (1) The disease of patients in eastern Taiwan are comparable to those in western Taiwan. However, the ratio of elderly visiting the ED in eastern Taiwan was lower. Further study is needed to verify whether there are more seriously ill patients in eastern Taiwan. (2) The quality of the ED in this hospital is good but, there is still room for improvement. (3) After the hospital was upgraded to a medical center, the number of severely ill patients obviously increased. (Tzu Chi Med J 2001; 13:223-229) |
本系統中英文摘要資訊取自各篇刊載內容。