The Analysis of Emergency Medical Resources Utilization and Patient Revisits to the Emergency Department in Taiwan
Date Issued
2005
Date
2005
Author(s)
Lai, Chun-Chi
DOI
zh-TW
Abstract
Emergency department revisits will increase medical costs, and it is the warning of medical quality, too. As a result of developing emergency medicine and practicing National Health Insurance (NHI), the emergency service volume is growing up year by year in Taiwan. In 2002, emergency service volume is 6,600,872 visits, and emergency medical expenditures are 880 million. It relies on monitoring medical quality index practically on purpose to distribute medical resources fairly, improve medical quality and public health, and insure National Health Insurance sustainable operation. Analysis of revisits to the emergency department can induce medical costs and improve the quality of emergency medicine.
Purpose: The objectives of this study were to evaluate the ‘emergency medical resources utilization’, ‘the characters of patient and hospitals with three days revisits’, and ‘emergency medical expenditures of different revisiting types’ in Taiwan during 2002.
Method: A cross-sectional study was conducted by using claim data of NHI and Department of Health (DOH) in 2002.
Result: The result of study finds (1) there are 5,431,414 visits of emergency department within 20 times in 2002, the medical expenditures are 9,157,936,407 dollars (NT), and the rate of return to the emergency department in three days is 6.56%. (2) There are more emergency men (52.94%) than women (45.95%), and the men’s rate of emergency utilization and revisit are higher than women’s. (3) In age, the 15 to 65 years old are 59.32% of the proportions. The over 65 years elder’s rate of emergency utilization and revisit are highest, secondly it is 0 to 14 years old. (4) The first four items of primary diagnosed are ‘injury and poisoning’, ‘diseases of the respiratory system’, ‘symptoms, signs, and ill-defined conditions’, ‘diseases of the digestive system’. The highest first three items of emergency revisits are ‘neoplasms’, ‘mental disorders’, ’diseases of the circulatory system’. (5) Analyzing the different types of emergency department revisits find that the emergency medical costs of revisiting to higher level hospitals are highest, the next is the emergency medical costs of revisiting to the same level hospitals, the next is the emergency medical costs of revisiting to lower level hospitals, and the emergency medical costs of revisiting to the same hospital are lowest.
Conclusion: Based on the result, we suggest that the government departments should monitor emergency medical quality index continually, implement classified medicine, and establish emergency transfer system. To the first three of the revisit diseases are neoplasms, mental disorders, and diseases of the circulatory system, we should provide enough and appropriate hospitalization in order to reduce emergency revisits. The government departments could monitor patient who revisits between hospitals by IC cards and save medical reports in IC cards. Emergency departments should look out the patients who are men, over 65 years old, and diagnosed by tumors, psychological disorders, and circulatory system diseases. At last, the government departments should implement family doctor systems for reducing medical resources wasted and improving medical quality.
Subjects
急診
重返急診
再急診率
醫療資源耗用
醫療品質
emergency services
emergency department revisits
revisit rate
utilization of medical resources
medical quality
SDGs
Type
thesis
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