[轉錄][爆卦] 國民們! 你們將來背負的醫療負債更重了

[monyan (廢健保救台灣)]

※ [本文轉錄自 Gossiping 看板]

作者: explosion (爆炸) 看板: Gossiping
標題: [爆卦] 國民們! 你們將來背負的醫療負債更重了 
時間: Sat Apr  4 09:42:16 2009

美國已經注意到這個問題了,
再人口結構老化將近是全球第一的台灣,
我們的療系統是否有所準備?

他山之石, 可以大略了解, 到底誰才是使醫療保健財政日漸窘迫的首要因素?
若不改革制度
僅是繼續追討欠款 or 增加人民保費
完全無益於克服顯而易見而且緊迫逼人的健康人口改變

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The Growing Older Population’s Effect on Emergency Care
日漸成長的老人族群對於急診醫療照顧的衝擊

— Richard D. Zane, MD, FAAEM 理查贊恩 醫師 美國急診醫學會會員

ED visit rates among patients aged 65 to 74 increased 34% from 1993 to 2003.
從1993到2003年, 65歲到74歲年紀群的急診病人來診量, 增加了34%

Among the many factors thought to contribute to emergency department
overcrowding are an increase not only in the number of patients but also in
the complexity of cases. Older patients are a challenge because they
typically require more-complex evaluations, have longer ED length of stays,
and have higher rates of hospitalization than do younger patients.
不僅僅是病人數量, 而且病情的複雜度增加, 都導致了急診的過度擁擠. 相對於年輕病
人, 老年病人需要更繁複的檢查, 有較長的急診留觀時間, 也有較高的住院機率.

These authors used data from the National Hospital Ambulatory Medical Care
Survey to determine trends in ED visit rates for patients older than 65
from 1993 to 2003. During the study period, ED visits for patients aged 65
to 74 increased 34%; visits for patients older than 74 did not increase
significantly. Visit rates increased 93% for black patients and 26% for
white patients. Visit-rate increases were similar for men and women. Based
on the number of medications administered and admission rate as an
indirect gauge of visit complexity, the number of visits in which three or
more medications were prescribed increased 44%, whereas the admission rate
did not change significantly (although it varied year to year). On the
basis of these data, the authors estimate that ED visits in the U.S. among
patients aged 65 to 74 will double from 6.4 million to 11.7 million by 2013.

這些作者使用來自於National Hospital Ambulatory Medical Care Survey的資料來決
定1993到2003年, 65歲以上的急診病人量. 65-74歲的病人數增加了34%; 大於74歲以
上的病人比例沒有明顯增加. 黑人病人量增加了93%, 白人增加了26%. 男性與女性病人
比例差不多. 用給予不同藥物的數量, 還有住院比例來間接評估病情的複雜度而言,
開立三種以上藥物的病人數量增加了44%, 然而住院比例並沒有明顯增加 (雖然每年
不大相同). 根據以上資料, 作者評估到達2013年, 65-74歲的急診病人族群會從640
萬人增加到1170萬人次.

Comment: Persons older than 65 are the fastest growing demographic in the
U.S. Planning for delivery of healthcare for the entire population must
address the effect that this growing older population will have on the
provision of emergency care. The solution will have to involve more than
just building bigger EDs because the increased burden will involve not
only the number of patients seeking emergency care but also the complexity
of cases.

評語: 65歲以上的老人是美國急診病人中增加最快速的族群. 計畫給予全體國人醫療
照顧的同時, 也必須強調這個老人族群數量的增加, 會對急診醫療照顧所帶來的衝擊.
 解決之道不僅僅是蓋更大的急診, 因為除了病人量的增加, 也包括病情複雜度的增加.


引用期刊:
Roberts DC et al. Increasing rates of emergency department visits for
elderly patients in the United States, 1993 to 2003. Ann Emerg Med 2008
Jun; 51:769.

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推 pest:台灣還有第三招 打壓醫療價格 這是美國不敢做的
→ kreeselack:要是有政治界的彭神就好啦Q___Q
推 ming088:在台灣以為只要有國民年金 只要發錢 什麼都可以解決了
推 HYL:一樓不了解 Obama最近的政策...
→ amaki:Obama也是打算要推全民健保，似乎打壓醫師所得是這幾年趨勢
→ joanne770429:標題有誤 區民們才對                            慘
推 ea00382:跟戰後嬰兒潮有關吧 不過台灣的情形....是有一點像啦
推 madguy:到急診待個半天觀察一下，就會發現有很多是可以看門診的。
→ madguy:扣掉這些可以改掛門診的，不但可以節省健保支出，
→ madguy:也可以讓真正需要急診的人得到較好的照顧。
推 monyan:所以健保一定倒
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