A Study of Holiday Effect on Resource and Outcome of Treating AMI

• Main Authors: Hua-Ching Shih, 施華菁
• Other Authors: Ching-Wen Chien
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/00920096674785253074

碩士 === 國立陽明大學 === 醫務管理研究所 === 96 === Objectives: Recently, issues about the medical quality and patient’s safety are deeply concerned due to the rising of medical awareness by the people. The discrepancy of medical service between the duty period (night time, weekend, and the Holiday) and the daytime is relevant to the medical consequence and utilization of resources of the health insurance. We search for the patients having the first attack of AMI (acute myocardial infarction), analyze the risk factors of admission and the consumption of medical resources during post-discharge survival period. Two groups were divided by the holiday and non-holiday. The results can be referenced by the managerial administration the hospital. Methods: By selecting the patient having the health insurance of Taipei metropolitan area, two groups were divided by holiday and non-holiday at the community hospital and the medical center. The statistical methods used are Chi-Square test, Cox regression and Generalized Estimation Equation. Results: The mortality rate of the AMI patient was relative to the factors of age (p=0.000), complication score (p=0.010) and authority type of admitting hospital (p=0.004). The factors influencing the consumption of medical resources during the 540 days of post-discharge survival periods are complication score (p<0.01) and survival time (p<0.001). The higher the complication score is and the more the consumption of the medical resource. However, the consumption of the medical resources is decreasing while the survival time increases. The longer the survival time causes the flatness of the decreasing of the consumption of the medical resources. Conclusion: At the Taipei metropolitan which have well medical network and level, there is no difference of the first attacked AMI patient between the medical outcome and prognosis of the consumption of medical resources during the hospital visiting of the holiday. The key factors according to the study are age and complication! Due to the increased aging people, the distribution of the people of the social is changing. We recommend that the medical administrator should work and focus on geriatrics, preventive medicine and the disease management which will offer much more efficient medical services.