The difference of urgency, medical quality and medical consumptions among different age regimens of geriatric emergency patients under Taiwan Triage and Acuity Scale (TTAS)

• Main Authors: Tiing Soon Ling, 林忠順
• Other Authors: K. H. Hsu
• Format: Others
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/05349844374179957932

碩士 === 長庚大學 === 商管專業學院碩士學位學程在職專班醫務管理組 === 101 === Emergency department is facing the problem of overcrowding due to increasing number of emergency patients in Taiwan. A new Emergency department triage system ─ Taiwan Triage Acuity Scale(TTAS) was implemented since 1st ,January 2010.However, there are limited studies on the appropriateness of applying the new triage system, especially to the elderly emergency patients. A retrospective data and longitudinal analysis was therefore conducted in this study. The sample size study was 87,494 elderly patients aged ≧65 in this thesis. The χ2 and ANOVA statistics were applied in the univariate analysis. Regression models were used for multivariable analysis. Results: 1)Severity: the medical urgency (level 1 and 2) of the elderly patient was increased while age increased：Age 65-74, level 1 (4.1%), level 2 (27%), Age 75-84, level 1 (6.2%), level 2 (33.3%), Age ≧85, level 1 (8.5%), level 2 (37.8%). Poor prognosis were also increased while the age of the elderly patient increased：Age 65-74, mortality 1.1%, admission 44%, discharge 54.89%, Age 75-84, mortality 1.56%, admission 50.24%, discharge 48.21%, Age ≧85, mortality 3.15%, admission 53.7%, discharge 43.2%；2)Structure: The mean ED length of stay was increased while age of the elderly patients increased. Age 65-74 1131.75 minutes, Age 75-84 1330.56 minutes, Age >=85 1414.7 minutes；3)Medical utilisation: the examination of X-ray and CT investigations were increased while the age of the elderly patient increased. However, the specialities consultations were decreased while the age of the patients increased；4)Medical consumptions: Total ED medical expenses: Age 65-74(NT$7,047), Age 75-84(NT$7,816), Age ≧85 (NT$8,008). Total medical expenses: Age 65-74(NT$101,996), Age 75-84 (NT$101,502), Age ≧85(NT$96,385). In summary, different age regimens of elderly ED patients are significantly differentiated on varied study constructs under TTAS. The findings suggest to develop a treatment protocol and practice guideline specific for different age regimens of elderly ED patients. With such an effective management interventions, the care quality and efficiency of elderly ED patients can be improved in the future.