急診醫療服務與其它醫療服務之類別間關係

Relationship of Utilization of Emergency Medical Services and Other Medical Services

10.6288/TJPH2006-25-05-07

黃金安(Jin-An Huang)；賴其勛(Chi-Shiun Lai)；胡哲生(Jer-San Hu)

急診醫療服務 ； 類別間關係 ； 醫療利用 ； Emergency medical services ； intercategory relationship ； medical care utilization

台灣公共衛生雜誌

25卷5期（2006 / 10 / 01）

384 - 393

繁體中文

Objectives: Following implementation of the global budget payment system, understanding the relationships between service use between specialties has become essential for hospital management and health policy makers. The purpose of this study was to explore the intercategorical relationships of emergency and other medical services. Methods: This study used nationwide claims data for the year 2001 from the National Health Insurance Research Database in Taiwan. Data from 6,996 insured individuals who had used emergency medical services were included. Multiple regression and logistic regression analyses were used to determine relationships among various medical services. Results: Elderly patients, patients who frequently used outpatient (OPD) services, and patients with frequent admissions tended to be frequent ED users (p＜0.001). High utilization of outpatient and primary care services and frequent hospital admissions were significantly correlated with emergency service use after controlling for age and gender (p＜0.001). Odds Ratios were 10.29 (95% CI: 7.65-13.84), 5.43 (4.15-7.11), and 1.46 (1.11-1.93), respectively, for outpatient use, hospital admissions, and primary care use. Conclusion: Hospital OPD use, hospital admission and primary care use all have an impact on ED use. Frequent ED users are more likely to use other medical services. In other words, there is an intercategorical relationship between ED use and use of other medical services.

Objectives: Following implementation of the global budget payment system, understanding the relationships between service use between specialties has become essential for hospital management and health policy makers. The purpose of this study was to explore the intercategorical relationships of emergency and other medical services. Methods: This study used nationwide claims data for the year 2001 from the National Health Insurance Research Database in Taiwan. Data from 6,996 insured individuals who had used emergency medical services were included. Multiple regression and logistic regression analyses were used to determine relationships among various medical services. Results: Elderly patients, patients who frequently used outpatient (OPD) services, and patients with frequent admissions tended to be frequent ED users (p＜0.001). High utilization of outpatient and primary care services and frequent hospital admissions were significantly correlated with emergency service use after controlling for age and gender (p＜0.001). Odds Ratios were 10.29 (95% CI: 7.65-13.84), 5.43 (4.15-7.11), and 1.46 (1.11-1.93), respectively, for outpatient use, hospital admissions, and primary care use. Conclusion: Hospital OPD use, hospital admission and primary care use all have an impact on ED use. Frequent ED users are more likely to use other medical services. In other words, there is an intercategorical relationship between ED use and use of other medical services.

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