2014-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/642830摘要：緊急醫療服務（Emergency Medical Service, 以下簡稱EMS）提供各種急重症傷病患者第一線的醫療照護，能即時於現場給予患者緊急的醫療處置，並運送至醫療單位，同時在運送過程中給予到院前必要的醫療照護。近年來，EMS 的需求呈現高度的增長趨勢，年均複合增長率達7％，同時也已突破每年百萬件次。本團隊成員在近幾年與新北市政府消防局、台北市政府消防局以及行政院衛生福利部合作，針對我國緊急醫療網、急重症資源分佈以及到院前心肺功能停止（Out Of Hospital Cardiac Arrest；簡稱OHCA）病患存活率進行分析，以評估各種到院前緊急救護處置（Pre-hospital emergency treatment）的實際效果。分析結果顯示，根據傷患狀況的不同，現場的醫療處置與運送的決策對傷患的存活率影響頗大。也就是說，對於某些類型的傷患，現場有無高級的緊急救護技術員（Advanced EmergencyMedical Technician）或只有一般的緊急救護技術員以及能否在最短的時間內運送至區域醫院等級以上的醫療院所是傷患能否存活的關鍵。然而，對於某些類型的傷患，是否運送至地區醫院或是醫學中心則影響不大，反倒是運送時間的長短影響較大。這樣的結果告訴我們，緊急醫療服務的資源配置，必須考慮到各地區主要傷患的型態、人口分佈、交通網路的狀況、醫療院所的等級種種因素，方能規畫出一套能以最經濟的方式提供最完善的服務的網路。舉凡說，那些地區需要增加消防隊舍、那些地區需要提升地區醫院緊急醫療服務的能力、那些地區需要增加高級緊急救護技術員的員額、那些地區需要根據一年中不同時期設置浮動緊急救護站、及那些地區需要特別加強民眾的認識與訓練等等問題都需要以嚴謹的資料分析為基礎，作為決策依據。基於上述的認知，本計畫成員將配合衛生福利部緊急醫療網現有資料，加以除錯導入一個可配合不同地理圖資進行多變量分析的資料庫，同時整合各種自然原因或意外事故所造成的傷病患狀況、到院前急救服務記錄、以及患者預後等資訊，同時結合人口特質、地理因素、以及醫療和消防資源分配等空間資訊進行資料探勘，以期能一套緊急醫療服務資源配置的最佳化決策機。這樣的機制不僅能保障國民在需要緊急醫療救護時都能得到最妥善的照護，同時由於緊急醫療救護的績效已成為一個國家先進程度的重要指標，本計畫的成果更能增加我國在國際社會的能見度。<br> Abstract: Emergency Medical Service (EMS) provides the first-handed medical care for all kinds of emergencyand critical patients, including on-site emergency treatments and necessary pre-hospital medical care duringtransportation. In Taiwan, the demand for EMS has increased over 7% annually in recent years and thenumber of cases has reached 1 million per year.Team members of this project have worked with the Fire Department of New Taipei City to investigatethe effects of all kinds of pre-hospital emergency treatments on the survival rate of patients who sufferedOut Of Hospital Cardiac Arrest (OHCA). The study has shown that the type of pre-hospital medical careand the decision of medical transportation have significant impact on the survival rate. In particular, forcertain types of patients, presence of advanced medical technician and follow-up medical treatments at adistrict hospital or a medical center are crucial. On the other hand, for some other types of patients, the mostcrucial factor is the transportation time to a hospital and the level of the hospital in which the patientreceived medical treatment did not make much difference. The study has concluded that resource allocationof EMS must take into account the prevailing types of patients in a region, population distribution,transportation networks, levels of nearby hospitals in order to configure an optimal network that candelivers high-quality and economical service. For example, all the decisions involving increase of regionalfire department facilities, upgrade of regional hospitals, increase of advanced medical technicians, setting upseasonal emergency medical stations, and promotion of civil awareness and training must be based on theresults from comprehensive data analysis.With the observations addressed above, the team members in this project will build up a databasecollecting patients’ conditions, pre-hospital medical records, and follow-up medical records in order toconduct comprehensive data mining by including geographical information such as populationcharacteristics, geographical characteristics, regional medical resources, fire department allocation. Theultimate objective is to develop an optimizing mechanism for EMS resource allocation. Such a mechanismnot only can provide citizens with high-quality EMS but also can promote Taiwan’s visibility in theinternational community since the quality of EMS has been listed as one of the critical index of statedevelopment.緊急醫療地理資訊系統資料探勘最佳化決策支持Emergency Medical ServiceEMSOut Of Hospital Cardiac ArrestOHCAResource PlanningMachine LearningSystem AnalysisPre-Hospital MedicineBig Data Analysis