頭部外傷原因與醫療資源耗用

Background and Purpose: Head injuries caused by unintentional and intentional incidents remain a global concern in the public-health agenda. The Years of Potential Life Lost (YPLL) resulting from such head injuries would appear to be much greater than corresponding numbers lost to cancers or to various cardiovascular diseases. Methods: This study is a population-based investigation of head injuries combining the total annual inpatient dataset acquired from The Bureau of National Health Insurance (BNHI), Taiwan, during the years 2000 to 2004 inclusively, and the domicile files of death certification issued by the Department of Health (DOH), Taiwan, this aspect of the research focusing, retrospectively, on analysis of the last five years of records for such head injuries. The impacts of the Mechanism of Injury (MOI), inpatient characteristics' distribution, and the medical resources utilized for treatment of such patients are analyzed herein. Results: An analysis of the relevant individual medical records for 43,239 head-injury patients over the period 2000 to 2004 inclusively suggested that the total hospitalization expense for such patients was NTD 2,799,103,526 with the average patient age being 43.3 years. The Average Length of Stay (LOS) in a medical institution was 11 days, and the average per-patient hospitalization expense was NTD 64.736. Traffic accidents accounted for 54.8% of the total patient number, and such injuries appeared to be concentrated amongst youth and teenagers, with an average age of 38.3 years, such individuals revealing an average per-person hospitalization expense of NTD 62,797. Amongst such a population, there were 17,996 persons (53.3%) who were victims of Motor Vehicle Traffic Accidents (MVTA) such individuals featuring an average age of 39.3 years, 10.7 days of LOS, an inpatient mortality rate of 5.8% and an average per-person hospitalization expense of NTD 63,242. Accidental falls was the second most-common mechanism of head MOI incorporating 10,486 persons (31%), featuring a greater average age of 55.9 years, as compared to traffic-accident victims, 15.7 days of LOS, a mortality rate of 10.4% and a larger average per-person hospitalization expense (NTD 100,111) than was the case for traffic-accident victims Accidental falls amongst elderly people would appear to be an emerging issue which clearly cannot be overlooked in an aging society such as is the case for Taiwan. Conclusion: Given the evidence presented herein, a nation's clinical services and health policymakers should allocate an appropriate level of medical resources in order to effectively deal with different injury patterns.