2000-2007年台灣地區事故傷害中主要損傷及其外在因素之健保住院費用分析

2000-2007 Medical Cost of Principle Injury and External Cause of Injury under National Health Insurance in Taiwan

目標：了解2000-2007年國人依據主要損傷及外在因素造成之事故傷害的健保住院醫療費用。方法：從國家衛生研究院全民健康保險學術研究資料庫中，擷取2000-2007年「住院醫療費用清單明細檔（DD）」之「診斷代碼」前三碼為800-999者及「外因分類」前四碼為E800~E999者，進行醫療費用分析，探討國人在不同年度、性別、年齡層之事故傷害主要損傷與外在因素，及其住院醫療費用耗用概況。結果：國人因主要損傷所造成之事故傷害前五位為：1.骨折、2.顱內及內部器官損傷、3.開放性傷口及血管傷害、4.內科及外科醫療上之併發症、5.其他損傷、創傷之早期併發症。而因外在因素造成國人之事故傷害前五位為：1.機動車輛之交通事故及非交通事故、2.意外墜落、3.其他意外事故及後期影響、4.內外科醫療過程及處置所導致意外事故、異常反應或後期併發症、5.治療用之藥品、藥物及生物製劑所致之不良影響。國人依主要損傷計算出的事故傷害之健保住院醫療費用，及因外在因素所造成的事故傷害之健保住院醫療費用，每年平均分別為86.6億元與115.4億元。結論：事故傷害不僅耗費鉅額醫療費用，且為國人之重大死因，建議相關單位應就本研究所列之事故傷害外在因素加強宣導與做好防範措施，以降低國人在事故傷害方面的傷亡與醫療耗費。

Object: The aim of this study was to realize the types of principal injuries, causes of injuries and the medical expense of inpatients between 2000 and 2007. Method: This study retrieved the data of diagnosis coding 800-999 and external causes coding E800-E999 in ICD-9-CM from 'Inpatient expenditures by admissions (DD)' in the National Health Insurance Research Database between 2000 and 2007. The data analysis was conducted in terms of principal injuries, the causes of injuries and the hospitalization of medical expense by different years, gender and age. Results: The top five types of principal injuries concludes as: fracture, intracranial and internal injuries including nerves, open wounds and injuries to blood vessels, complications during medical care, and early complications of other injuries. The top five causes of injuries include: traffic accidents and non-traffic accidents, accidental falls, other accidents including late effect, misadventures during medical care, abnormal reactions, late complications, and side effects of drugs. The average medical cost of principal injuries and causes of injuries are individually NT$8.66 billion and NT$11.54 billion. Conclusion: The injuries investigated in this study not only cost huge medical expense but also are the major causes of death in Taiwan. According to the results of this study, authorities should propose and develop injury prevention projects to reduce the medical expenses of injuries and death.