短期醫療支援某南太平洋島國就醫個案疾病型態分析研究

Disease Patterns of Short-term Overseas Medical Support in a South Pacific Country

背景與目的：海外醫療支援是國際醫療重點工作之一，是家庭醫學科社區經驗的一環，本研究的目的在探討短期醫療支援就醫民眾的疾病型態分析，以提供未來短期醫療支援團隊參考準備。方法：調查當地需求後派一般科與眼科醫師支援。收集兩年度某醫院國際醫療中心參與南太平洋某島國海外醫療支援病歷資料，登錄個案基本資料、就醫主訴、就醫診斷、醫囑建議，血壓與血糖值，轉診紀錄。分類以一般科（包含家庭醫學、內兒科）與眼科兩大部分。結果：排除性別與年齡資料不全者（68人）之後，總共有2,572人次就診，2010年為1,283人次，2011年有1,289人次。結果發現女性就醫較男性多，就醫年齡由出生後2週至91歲，平均年齡於一般科（家庭醫學科與內兒科）為37.4歲，而就診眼科平均年齡較高（51.2歲），以40至65歲中年者所占百分比最多。一般科就醫主訴以身體酸痛占最多，近四成有肌肉骨骼系統診斷；皮膚疾病與呼吸道疾病次之。高血壓與心血管疾病約13%，糖尿病有5.9%，年齡層越高罹病率越高。小於18歲者以皮膚與呼吸道疾病為主。眼科就醫主訴以視力問題為主，64.3%老花眼，17.3%老年性白內障，慢性結膜炎有13.7%。兩科就診個案有特殊的疾病需要轉診至醫院的轉診率為3%。結論：行動醫療團海外醫療支援雖然僅執行短期醫療服務，但是因當地醫療缺乏故受民眾重視，來診踴躍。主訴與疾病種類多屬家庭醫學科相關範圍，醫材藥材應依常見醫療需求與診斷做準備。

Background: Overseas medical support is an emerging issue in international health care and a part of our community experience in Family Medicine. This study investigated physician diagnoses found during our experience with overseas short-term medical support. Methods: After an evaluation of local needs, general practitioners and ophthalmologists were invited to join the team. We collected medical records during overseas medical support in a South Pacific country for two years. Data included basic information about cases, medical complaints, physicians' diagnoses and recommendations, measurements of blood pressure and blood sugar, prescriptions and referral records. We classified patients into two groups, one for the departments of family medicine, internal medicine, and pediatrics, and the other for the department of ophthalmology. Results: After patients with incomplete information about about gender and age were excluded, a total of 2572 individuals were seen over the 2-year period, 1283 in 2010 and 1289 in 2011. The results showed that more women than men sought medical treatment. Age ranged from 2 weeks to 91 years. The mean age was 37.4 in the general section, and 51.2 in ophthalmology. Most patients were aged 40-65. Most general medical patients complained of body aches, as musculoskeletal diagnoses accounted for nearly 40%. These were followed by skin diseases, respiratory diseases, hypertension, and cardiovascular diseases. Of the vision problems seen by ophthalmologists, 64.3% were presbyopia, 17.3% were cataracts, and 13.7% were chronic conjunctivitis. The referral rate was 3%. Conclusions: Although the overseas medical support team performs only short-term medical services, they are welcomed because of a lack of medical support in the local region. The chief complaints and types of diseases are mostly within the scope of family medicine. Medical supplies and medications should therefore be prepared in accordance with common medical needs.