Department of Emergency Medicine, Cheng-Ching General Hospital, Taichung 407, Taiwan, ROC.
Health Policy. 2011 May;100(2-3):189-95. doi: 10.1016/j.healthpol.2010.10.007. Epub 2010 Nov 4.
To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits.
A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.89% could be classified. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits.
Nearly 15% of all emergency department visits were nonemergent; an additional 20% were emergent-preventable with primary care. Patients likely to make nonemergent emergency department visits were older, female, categorized as a Taiwan National Health Insurance Category IV beneficiary, and without major illness. Hospital accreditation level, teaching status, and location were associated with an increased likelihood of nonemergent emergency department visits.
Understanding the factors leading to nonemergent emergency department visits can assist in evaluating the overall quality of a health care system and help reduce the use of the emergency department for nonemergent conditions. Policy makers desiring cost-effective care should assess emergency department visit rates in light of available resources for specific populations.
探讨在台湾全民健康保险计划下非紧急急诊就诊的规模，并确定与这些就诊相关的重要因素。
使用 2002 年台湾全民健康保险研究数据库的横断面分析，根据纽约大学算法确定非紧急急诊就诊的情况。数据包含 43384 次就诊，其中 83.89%可以分类。多变量逻辑回归确定与非紧急急诊就诊相关的个体和环境因素。
近 15%的所有急诊就诊是非紧急的；另有 20%可以通过初级保健预防紧急情况。可能进行非紧急急诊就诊的患者年龄较大、女性、被归类为台湾全民健康保险第四类受益人，并且没有重大疾病。医院认证级别、教学状态和位置与非紧急急诊就诊的可能性增加相关。
了解导致非紧急急诊就诊的因素可以帮助评估医疗保健系统的整体质量，并有助于减少因非紧急情况而使用急诊部门。希望提供具有成本效益的护理的政策制定者应根据特定人群的可用资源评估急诊就诊率。
