Wang Fu-Ting, Chang Yuhsuan, Chien Wu-Chien, Li Hung-Hui
College of Management, Yuan Ze University, Chungli, Taiwan.
College of Management & Innovation Center for Big Data and Digital Convergence, Yuan Ze University, Chungli, Taiwan.
Geriatr Gerontol Int. 2016 Dec;16(12):1254-1262. doi: 10.1111/ggi.12620. Epub 2015 Oct 13.
The purpose of the present study was to investigate the injury types and medical utilization profiles of veterans in emergency department visits by using big data from the National Health Insurance program in Taiwan.
We used the outpatient prescriptions and treatment records between 1997 and 2010 of veterans aged ≥65 years in the National Health Insurance Research Database. The International Classification of Diseases, Ninth Revision, Clinical Modification codes 800-999 (i.e. injuries) were selected, and the emergency medical treatment and the medical institutions' basic profile were recorded.
A total of 287 113 veterans were selected for this study. The average age was 77.4 years, and most participants were men (71.2%). The total medical expenses were US$46.0 million (an average of US$160.00 per person). Contusions/abrasions, open wounds, and fractures comprised 29.2%, 26.6% and 16.3% of the injuries, respectively. In addition, contusions/abrasions, open wounds, and fractures comprised 23.8%, 21.5% and 19.8%, respectively, of the total medical expenses. The highest charges for a single injury episode were for spinal cord and nerve injuries (an average of US$349.00 per person). Regarding sex differences, women mainly experienced fractures and contusions/abrasions, whereas men experienced open wounds.
The injury rate of veterans was reported higher than the non-veterans. Preventive methods are proposed to decrease the occurrences of injury, number of emergency visits and medical expenses. Geriatr Gerontol Int 2016; 16: 1254-1262.
本研究旨在利用台湾国民健康保险计划的大数据，调查退伍军人在急诊就诊时的损伤类型和医疗利用情况。
我们使用了国民健康保险研究数据库中1997年至2010年65岁及以上退伍军人的门诊处方和治疗记录。选择国际疾病分类第九版临床修订本代码800 - 999（即损伤），并记录急诊医疗治疗情况和医疗机构的基本概况。
本研究共纳入287113名退伍军人。平均年龄为77.4岁，大多数参与者为男性（71.2%）。总医疗费用为4600万美元（平均每人160美元）。挫伤/擦伤、开放性伤口和骨折分别占损伤的29.2%、26.6%和16.3%。此外，挫伤/擦伤、开放性伤口和骨折分别占总医疗费用的23.8%、21.5%和19.8%。单次损伤事件收费最高的是脊髓和神经损伤（平均每人349美元）。在性别差异方面，女性主要经历骨折和挫伤/擦伤，而男性经历开放性伤口。
据报道，退伍军人的损伤率高于非退伍军人。建议采取预防措施以减少损伤的发生、急诊就诊次数和医疗费用。《老年医学与老年病学国际杂志》2016年；16：1254 - 1262。
