老年病患之急診醫療使用

Emergency Department Utilization by Elderly Patients

10.29462/TGG.200705.0001

周明岳(Ming-Yueh Chou)；周上琳(Shang-Lin Chou)；陳亮恭(Liang-Kung Chen)；顏鴻章(David Hung-Tsang Yen)；薛光傑(Kuang-Chieh Hsueh)；顏良羽(Liang-Yu Yen)；黃信彰(Shinn-Jang Hwang)；杜明勳(Ming-Shium Tu)

老年的 ； 急診 ； 老年人 ； aged ； emergency service ； elderly

台灣老年醫學雜誌

2卷4期（2007 / 05 / 01）

225 - 233

繁體中文

由於老年病患往往具有多重疾病狀況及各種失能與認知功能障礙，故老年人使用醫療資源的需求急遽上升。老年人被認爲是高度使用急診醫療資源的族群，推估約有40.8%的急診醫療費用是使用在65歲以上的老年病患身上，而急診室也時常是老年病患進入急性醫療的主要管道。然而，與年輕病患相較，老年人在急診醫療資源的使用上有其不同特性與表現。一般來說，老年病患使用急診的比例較高、檢傷分類較偏向重度、使用救護車比率較高、停留時間較久、耗用較多醫療資源、住院率較高、表現較不典型而且預後較差。隨著人口快速老化，台灣已經進入老年社會，未來眾多的老年人口將對急診醫療資源產生很大的衝擊與負擔。然而，曾有國外報告顯示將近一半的急診室醫師認爲他們自己沒有足夠的信心來處理老年病患。藉由了解老年病患在急診室的特殊表現，將可以使急診醫師更瞭解老年病患的特性，以提供更好的醫療服務，並期待研擬出更完整的相關政策以提供所有高齡民眾合宜的急診醫療服務。

The need of emergent medical care for elderly patients is escalating due to their various co-morbidities, complex disabilities, and impaired cognition. Elderly patients are frequent users of emergency medical resources, and can account for 40.8% of the entire annual adult emergency care expenditure. Moreover, emergency department is usually elderly patients' first stop of seeking medical help in acute hospitals. Compared with the younger counterparts, elderly patients demonstrate distinctive characteristics. They tend to visit emergency department by ambulance, and tend to be triaged at higher levels, to stay longer at emergency department, to incur higher cost for each visit, to be admitted to hospitals, to present with atypical manifestations, and to have poorer prognosis after discharge. With a rapid aging of population, Taiwan will reach an aged society level in the near future, maybe accompanied by huge burdens of resource consumption and profound impacts on emergency medical care. The situation can be even more alarming as it has been reported that half of the emergency physicians are not competent to handle elderly patients. Therefore, understanding of the emergency department utilization of elderly patients may be helpful, further advanced strategy/policy for elderly emergency care is expected.