台灣18歲以下未成年人交通事故住院發生率與醫療資源耗用之相關因素

Incidence of and factors associated with medical costs of traffic injury-related hospitalization of children in Taiwan

10.6288/TJPH2012-31-06-05

張筑禎(Chu-Chen Chang)；林蕙欣(Hui-Hsin Lin)；林志銘(Chih-Ming Lin)

交通事故 ； 發生率 ； 住院天數 ； 醫療費用 ； 未成年人 ； Traffic accidents ； Incidence ； Length of stay ； Medical expense ； Children

台灣公共衛生雜誌

31卷6期（2012 / 12 / 01）

535 - 543

繁體中文

目標：分析台灣18歲以下未成年族群因交通事故住院之發生率，並探討個人、疾病及醫院因素與醫療資源耗用之相關性。方法：採用國家衛生研究院建置的2007-2009年健康保險住院醫療費用資料檔，依外因分類碼擷取診斷欄位為交通事故且年齡低於18歲之住院傷患，總計樣本19,781人。我們估計全國未成年人口交通事故住院發生率，並以對數轉換後之住院天數與醫療費用為結果變項，以多變項迴歸研析其與年齡、性別、醫院層級、手術處置與共病數等潛在相關因子之相關性。結果：台灣未成年人在這3年因交通事故導致19,781筆住院總計1,117.7千人日，醫療費用7.1億元。平均年住院發生率為105.9/105，平均住院天數與醫療費用分別為5.65天與35,903.5元。15-17歲男孩有最高之住院發生率(445.5/105)與醫療費用(41,029.2元)。年齡較大、女性、手術處置、高醫院層級與多共病數顯著增加住院天數。然而在調整住院天數後，除手術處置與高醫院層級外，男性、嬰兒與單純性傷害反而是造成醫療費用增加的因子。結論：台灣未成年人交通事故傷害耗用具體之健康照護資源，每年花費的住院醫療支出達2.37億元，且有許多相關因子值得後續研究。

Objectives: To study traffic injury-related hospitalization of children under 18 years of age in terms of incidence and factors related to medical costs. Methods: The 2007-2009 National Health Insurance Research Database was used to identify a total of 19,781 children under 18 years of age who were hospitalized with an external cause (E code) of traffic injury. The incidence of traffic injury-related hospitalization among children was estimated. The associations between potentially significant covariates (age, gender, accreditation level of hospital, surgical intervention, number of comorbid conditions) and log-transferred hospitalization cost and length of stays (LOSs) were examined with multivariate regression analysis. Results: The 19,781 traffic injury-related hospitalizations among children under 18 years of age from 2007 to 2009, resulted in more than 710 million NTD in inpatient charges and 1117.7 thousand person-days of hospitalization. The annual incidence rate of hospitalization was 105.9/105. Mean (SD) LOSs and hospital charges were 5.65 (6.57) days and 35 903.5 (77 358.0) NTD, respectively. Male adolescents aged 15 through 17 had the highest hospitalization rates (445.5 per 100 000) and medical cost (41029.2 NTD). Older age, being female, having a higher number of comorbid conditions, surgical intervention and a higher hospital accreditation level were significantly associated with longer LOSs. In addition to surgical intervention and accreditation level of the hospital, those who were male, infants, or without other comorbid conditions tended to incur higher hospital charges after adjustment for LOSs. Conclusions: Traffic injuries among children incur a substantial health care burden, with an annual cost for hospital care exceeding 237 million NTD. Many related factors are worthy of further study.