評估高齡化對台灣急診醫療之衝擊及可避免急診之因應建議
吳肖琪
DOI:10.6283/JOCSG.2015.3.1.35
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中文摘要 美國於2010年通過“Patient Protection and Affordable Care Act (PPACA)”，提供民眾可負擔、高品質、有效率的醫療保健服務；美國衛生部健康照護研究與品質局(AHRQ)開始以門診照護品質、公共衛生介入、健康照護系統、及術後照護過程等面向發展可避免急診指標；2011年我國急診人數為4,222,192人、次數為12,472,601人次、費用高達1,773,051.36千點，其中65歲以上老年人之急診醫療費用占整體之32.17%；隨著人口快速高齡化，未來急診醫療負荷為何？健保採論量計酬方式該如何避免急診發生？為本計畫擬探討之重點。
我國老人比率至2050年將達37.9%，2060年每五人即有一名老人，而85歲以上之老老人比例亦將逐年攀升；有鑑於急診醫療費用之成長，且面臨高齡化社會之衝擊，推估各年齡層人口之急診需求始可了解如何因應，如何藉由前端預防避免不必要急診之發生亦須被探討。
本計畫擬以兩年時間，以經建會人口推估等資料推估國內急診需求，評估高齡化對急診之衝擊，並分析不同年齡層老人可避免急診之現況及影響，發展本土化可避免急診指標，擬透過文獻彙整、次級資料分析、專家會議等方法，綜合兩年成果提出未來急診施政之發展建議。
關鍵字：緊急醫療、急診利用、可避免急診、實證資料
文章建立時間：2015-01-28
引用格式(APA)：
吳肖琪(2015)。 評估高齡化對台灣急診醫療之衝擊及可避免急診之因應建議。
福祉科技與服務管理學刊， 3(1)， 35-40。
Evaluation of the impact of aging population on emergency medicine and suggestions for avoidable emergency department visits
Wu, S.-C.
English Abstract The Patient Protection and Affordable Care Act (PPACA) was enacted by US Congress in 2010. The goal of the act is to offer affordable, high-quality, and effective health care for people. The Agency for Healthcare Research and Quality (AHRQ) has developed indicators to identify avoidable emergency admissions by quality of outpatient services, public health intervention, healthcare delivery systems and the quality of post-operative care.
In 2011, total emergency visits by people were 4,222,192; and the patient-times in emergency were 12,472,601. In addition, the medical expenditure was 1,773,051.36 thousand points and 32.17% of all expenses were contributed to people who are older than 65 years old. Today, aging is a critical issue in Taiwan. So, this project will focus on the trends of admitting to emergency department utilization, and the influence of fee-for-service on reducing emergency department admission.
According to the report from Taiwan government, the proportion of aging population will be 37.9% in 2050. Not only will aging people but also the cost of emergence department increase rapidly year by year; therefore, it is important to diminish avoidable emergency department utilization by early prevention.
This project will evaluate the needs of emergency in the older population by using the CEPD population data in the first year. And next year this project will analyze conditions of avoidable emergency department in aging people and establish indicators that are suitable for Taiwan’s health care system by using literature review, secondary data analysis, and experts meeting.Keywords：emergency medicine, emergency department utilization, avoidable emergency admissions, evidence-based data