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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 楊銘欽 | |
| dc.contributor.author | Pei-Hsuan Lin | en |
| dc.contributor.author | 林佩萱 | zh_TW |
| dc.date.accessioned | 2021-05-19T17:53:34Z | - |
| dc.date.available | 2022-09-12 | |
| dc.date.available | 2021-05-19T17:53:34Z | - |
| dc.date.copyright | 2017-09-12 | |
| dc.date.issued | 2017 | |
| dc.date.submitted | 2017-06-29 | |
| dc.identifier.citation | 中文文獻
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Nonemergent emergency department use among patients with a usual source of care. J Am Board Fam Med, 26(6), 680-691. doi:10.3122/jabfm.2013.06.120327 Weiss, A. L., D'Angelo, L. J., & Rucker, A. C. (2014). Adolescent Use of the Emergency Department Instead of the Primary Care Provider: Who, Why, and How Urgent? Journal of Adolescent Health, 54(4), 416-420. doi:10.1016/j.jadohealth.2013.09.009 | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/7787 | - |
| dc.description.abstract | 目的：本研究旨在了解國內非緊急急診利用情形，並探討病患個人特質及區域醫療資源與非緊急急診利用的相關性。
方法：使用全民健保研究資料庫2010年承保抽樣歸人檔，以2013年非外傷急診就醫紀錄110,338人次，歸戶後共67,224位成年人為研究對象。本研究將臺灣急診檢傷與急迫度分級量表第四級、第五級之個案定義為非緊急急診，分別以廣義估計方程式(GEE)和二部模型(two-part model)進行分析。 結果：非緊急急診比率為18.3%，居住地基層醫師占率較高者，有非緊急急診利用的機率顯著較低(OR=0.70)；年齡、收入、共病症、門診照護連續性及是否為假日就醫是非緊急急診利用的相關因素。 結論：研究結果顯示，區域醫療資源與非緊急急診利用相關。建議衛生主管機關未來在制定相關政策時，應考量基層醫療資源配置，同時提供充分就醫場所資訊供民眾參考，以提高醫療資源使用效率。 | zh_TW |
| dc.description.abstract | Objectives: Policymakers have increasingly focused on emergency department (ED) utilization for non-urgent conditions. This study aims to explore non-urgent emergency department use in Taiwan and to determine the association between healthcare resources and presentation to ED with non-urgent conditions.
Method: This study included 110,338 ED visits in 2013 made by 67,224 adult ED patients selected from National Health Insurance Research Database. ED visits triaged as level 4 or level 5 based on Taiwan Triage and Acuity Scale (TTAS) were defined as non-urgent ED use. Generalized estimating equation (GEE) and two-part model were performed to identify the factors associated with non-urgent ED use. Result: 18.3% of total ED visits were non-urgent in 2013. People from areas with higher proportion of primary care physicians are less likely to present to EDs for non-urgent conditions (OR=0.70). Characteristics such as age, income, comorbidities, continuity of ambulatory care and seeking care on holidays are associated with non-urgent ED use. Conclusion: The results indicated that access to primary care providers was associated with non-urgent ED use. To improve the efficiency of healthcare resource utilization, primary care resource allocation should be considered. | en |
| dc.description.provenance | Made available in DSpace on 2021-05-19T17:53:34Z (GMT). No. of bitstreams: 1 ntu-106-R04848007-1.pdf: 2318399 bytes, checksum: 666c6b8ecb8737c6436d30e46be99b41 (MD5) Previous issue date: 2017 | en |
| dc.description.tableofcontents | 口試委員會審定書 i
誌謝 ii 中文摘要 iii Abstract iv 目錄 v 表目錄 vii 圖目錄 viii 第一章 緒論 1 第一節 研究背景 1 第二節 研究目的 2 第三節 研究重要性 2 第二章 文獻探討 3 第一節 非緊急急診之定義與概況 3 第二節 醫療服務利用行為模式 9 第三節 二部模型(Two-part Model) 11 第四節 非緊急急診利用之實證研究 14 第五節 文獻綜合討論 23 第三章 研究材料與方法 24 第一節 研究架構與研究假說 24 第二節 資料來源與研究對象 26 第三節 研究變項與操作型定義 28 第四節 資料處理與統計分析 32 第四章 研究結果 35 第一節 單次急診之描述性統計 35 第二節 單次急診之推論性統計 40 第三節 歸戶後樣本之描述性統計 45 第四節 歸戶後樣本之推論性統計 47 第五章 討論 53 第一節 重要研究結果之討論 53 第二節 假說驗證 58 第三節 研究限制 59 第六章 結論與建議 60 第一節 結論 60 第二節 建議 61 參考文獻 62 附錄 68 | |
| dc.language.iso | zh-TW | |
| dc.title | 區域醫療資源與非緊急急診利用之相關性探討 | zh_TW |
| dc.title | The Association between Regional Medical Resources and
Non-urgent Emergency Department Use | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 105-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 湯澡薰,董鈺琪 | |
| dc.subject.keyword | 急診,非緊急急診,基層醫療資源,二部模型,全民健保研究資料庫, | zh_TW |
| dc.subject.keyword | emergency department,non-urgent emergency department use,primary care access,two-part model,National Health Insurance Research Database, | en |
| dc.relation.page | 73 | |
| dc.identifier.doi | 10.6342/NTU201701203 | |
| dc.rights.note | 同意授權(全球公開) | |
| dc.date.accepted | 2017-06-29 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 健康政策與管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
文件中的檔案：
| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| ntu-106-1.pdf | 2.26 MB | Adobe PDF | 檢視/開啟 |
系統中的文件，除了特別指名其著作權條款之外，均受到著作權保護，並且保留所有的權利。