禽流感疫情爆發情境下醫院之抗疫能力模擬分析－以署立專責醫院為例

Simulation Analysis of a Hospital's anti-avian Flu Saturation Capability in Various Outbreak Scenarios

10.6288/TJPH2010-29-06-11

王貴民(Kuei-Min Wang)；惠霖(Lin Hui)；陳心慧(Sin-Huei Chen)；許貴婷(Gui-Ting Xu)

模擬 ； 負壓病房 ； 等候時間 ； 情境 ； 瓶頸 ； simulation ； NPIR ； waiting time ； scenario ； bottleneck

台灣公共衛生雜誌

29卷6期（2010 / 12 / 01）

575 - 582

繁體中文

目標：2003年嚴重急性呼吸道症侯群(SARS)所帶來嚴重衝擊，驚醒國人，政府隨之擬訂流感大流行作戰等計畫，建立抗疫能量，以因應可能發生之流感疫情。本研究目標係針對禽流感疫情爆發時專責醫院之設計能量達成抗疫任務程度進行分析。方法：依與專責醫院訪談結果建立概念性模型，發展醫院抗疫系統模擬模型。結果：以醫院能力可持續作業之時間長度（日）為量測指標，針對政府設計專責醫院之現有資源，融入衛生署應用之疫情情境進行模擬分析。疫情情境有四種設定：推估狀況、最小疫情、可能實況與最壞狀況；模擬出之醫院抗疫作業飽和能量分別為9、1、1、1日。醫療瓶頸出現於疫病篩檢站與負壓病房。結論：指定專責抗疫醫院之現況設計與整備難以因應前述四種情境之能量需求。疫病篩檢站與負壓病房之不足，形成醫療作業嚴重瓶頸，另衍生出大量轉院之病患之管理議題。

Objective: Since 2003, SARS has been a major problem in Taiwan and the government has started to develop and issue anti-avian flu plans in order to respond to probable epidemic situations in the future. The objective of this paper was to analyze the saturation capability of the government owned anti-avian flu hospital in four avian flu outbreak scenarios including estimated, least impact, most likely and worst case. Methods: A Conceptual Model (CM) was built and validated with support from the medical staff of the collaborating hospital. Based on the CM, a system simulation model was developed to obtain the Measure Of Effectiveness (MOE) from simulating the interactions of patients and the medical process in the hospital. Results: the hospital’s saturation capability (days) in terms of the given scenarios was 9, 1, 1, 1. Conclusions: The design of the government owned hospital is incapable of dealing with the given outbreak scenarios. Bottlenecks in the medical process are easily built up at the Plague station and in Negative Pressure Isolation Rooms (NPIR) which are equipped with only 53 beds. Another issue observed during simulation was the management of huge lines of patients waiting to be transferred after the hospital was saturated.

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