A analysis of the relationship between the triage of Emergency Department, patient structure and medical resource use

Autor:	Hsiao-En Chen, 陳曉恩
Rok vydání:	2007
Druh dokumentu:	學位論文 ; thesis
Popis:	95 The bigger population for emergency treatment and the diversity and complication of the type of diseases are the joint trends of emergency treatment environment. Besides the growth of population, the reason which affects the increase of the population for emergency treatment is partly because the huge increase of non-emergency patients. So we have to find an appropriate way to release the cram of the emergency department to let the patients who indeed need emergency treatment get the most appropriate care. The triage for the patients is the first border checkpoint of the emergency treatment；the main goal of the triage for the patients is to choose patients and the purpose is to use adequate resources on right people in right way at right time. The purpose of the research is to discuss the status quo of the emergency Patients、to understand and analyze of the relationship between the triage of Emergency Department, patient structure and medical resource use. I hope it could be the reference to the government. The purpose of the research : 一、 To describe the status quo of the use of the resources of the emergency treatment and the distribution of the medical resources. Classify the data of the emergencies into different types and then describe the distribution of the process of the emergency 、understand the characteristic of the patients and the hospitals and the use of the medical resources. 二、 To analyze the relationship between the triage of Emergency Department, patient structure and medical resource use. Method: A cross-sectional study was conducted by using claim data of NHI from July 2004 to Jun 2005. Result:: the research shows that triage of the most emergency cases are of the third class and the medical expenditures are of the second class. In different hospitals are most of the third class, and then are the second 、the first、and the fourth class. And the percentage of the fourth class of the triage of the emergency treatment patients is between 0%~1%. If we analyze different levels of hospitals and grades of the patients, we’ll find out the divergence is quite large in the same grade of different levels of hospitals. The average medical expenditures of the first class (the fee of a physician is not included) is between 2,163~7,567 points/per case ; the average medical expenditures of the second class (the fee of a physician is not included) is between 1,221~3,614 points/per case ; the average medical expenditures of the third class (the fee of a physician is not included) is between 641~1,884 points/per case ; The average medical expenditures of the fourth class (the fee of a physician is not included) is between 324~1,236 points/per case. The grade of the patients and the medical expenditures are highly relevant, which shows if the grade is higher, the expenditures will be higher. Also, the level of the hospital and the medical expenditures are highly relevant, too. It shows that if the level of the hospital is higher, the fare will be higher, too. If we analyze from the point of ages and sexes, we’ll find out that male’s expenditures is higher than female’s ; the expenditures of older ones is higher than the younger ones’. It shows that the need of emergency treatment and the drain of medical resources for males are higher than females. If we analyze from the level of the hospital, we’ll find out that the expenditures of private hospitals is higher than the expenditures of public ones. Finally we’ll also find that the expenditures of the emergency treatment of the medical center is the most, and then is the regional hospital and last is the local hospital. Conclusion: from the point of medical economy : Because we have the situation of the profession is not equal, so if the pay is fee for service, the problem of the lure of the need will appear. Now the pay of the health insurance physician fee is according to the triage class of the emergency treatment patients and which will cause the distribution of the class is not average. So the system of the triage of the emergency treatment patients may not reflect the real situation of the practical medical need. We suggest the system can be reexamined. The most 4 emergency disease are 1: damages and poisonous. 2: the unknown diseases. 3: respiratory problems. 4: digestion system problems. The most cases of the first class triage of emergency treatment patients are respiratory problems; the most cases of the second class triage of emergency treatment patients are damages and poisonous cases ; the most cases of the third class triage of emergency treatment patients are respiratory problems, too. Because the main purpose of the emergency treatment is to make sure all patients can get the appropriate treatments, how to provide these in limited time and human resources is the one we have to care from thorough education training. Different patients need different treatments and this could be the basis of human education training courses.
Databáze:	Networked Digital Library of Theses & Dissertations
Externí odkaz:	http://ndltd.ncl.edu.tw/handle/85081132679669575399 Zobrazit plný text záznamu