Exploring the Utilization of Emergency Department by Psychiatric Patients

• Main Authors: Hsin-Yi Lin, 林欣宜
• Other Authors: Rhay-Hung Weng
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/axmerf

碩士 === 嘉南藥理科技大學 === 醫療資訊管理研究所 === 99 === Abstract Background and Purpose Recently, the numbers of psychiatric patients have grown increasingly. Many researches indicated that psychiatric patients might be frequent emergency department users; therefore, the purpose of this study was to analyze the utilization of emergency department by psychiatric patients. Methodology This study adopted the retrospective study design and also used Aday and Andersen’s health behavior model as a main research structure. 95,435 samples were collected from psychiatric inpatient medical claim dataset of National Health Insurance Research Database from 2002 to 2007. Descriptive statistics, student t-test, one-way ANOVA, logistic regression, and multiple regression were used to analyze the utilization of emergency department by psychiatric patients. Results In this study, 16.11% of all samples have utilized emergency department. The average number of emergency department visits was 0.43 and average expenditure of emergency department services was NTD 1,184.5 per person per year. The likelihood of using the emergency medical services would be higher when the samples were women under 20 years old, insurance status as employers, the premium-based monthly salary of NTD17,281- NTD36,300 and NTD72,801 - NTD131,700 per person, the number of emergency physicians per 10,000 population was under 0.30, the number of psychiatry physician per 10,000 population was 0.31-0.61 or more. In addition, there would be higher likelihood of intensive using the emergency medical services when the samples were 31-50 year-old women, the premium-based monthly salary of NTD$17,280 or less, the number of psychiatrists per million population was more than 0.31-0.61, non co-payment policy, with chronic diseases. In medical expenses, there would be higher emergency medical costs when the samples were men aged 31-61, the premium-based monthly salary of NTD17,280 or less, the number of emergency physicians per 10,000 population was under 0.30, the number of psychiatrists per 10,000 population was over 0.61, non co-payment policy, with chronic diseases. Conclusion and Suggestions Government should take effort to promote the timing of using emergency service and Family Physician System to psychiatric patients and their families by different ways. Medical care personnel should inform psychiatric patients and their families how to take care by themselves after emergency department visits. The medical institutions should transfer the patients to outpatient or inpatient departments as soon as possible and establish emergency clinics so that non-urgent patients could transfer to emergency clinics. In addition hospitals also should accompany with community medical services to develop integrated cares for psychiatric patients. Keyword: psychiatric patients, emergency department, utilization of medical service, frequency of health care use, expenditure of medical services, National Health Insurance.