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    題名: Association of interleukin 10 and receptor antagonist gene polymorphisms with primary open-angle glaucoma
    作者: Lin, HJ;Tsai, SC;Tsai, FJ;Chen, WC;Tsai, JJP;Hsu, CD
    貢獻者: 附設醫院基因醫學部;China Med Coll Hosp, Dept Med Genet & Pediat, Taichung 404, Taiwan;China Med Coll Hosp, Dept Ophthalmol, Taichung 404, Taiwan;Taichung Healthcare & Management Univ, Grad Inst Bioinformat, Taichung, Taiwan;Tunghai Univ, Dept Biol, Taichung 40704, Taiwan;Tunghai Univ, Life Sci Res Ctr, Taichung 40704, Taiwan
    日期: 2003
    上傳時間: 2010-09-24 14:45:45 (UTC+8)
    出版者: KARGER
    摘要: Background and Purpose: Overuse of emergency department (ED) services can result in overcrowding and a substantial increase of health care cost. The purpose of this study was to characterize frequent ED users and to identify the factors associated with frequent ED use in a hospital in Taiwan. Methods: This retrospective study used Andersen's Behavioral Model of Health Service Use as a framework. Frequent ED users (greater than or equal to 4 visits/year) and infrequent ED users (< 4 visits/ year) were selected randomly from patients visiting the adult ED of a medical center in central Taiwan from October 1, 2000 to September 30,2001. Telephone interviews were completed for 200 frequent users and, 600 infrequent users. Logistic regression analysis was performed to identify factors associated with frequent ED use. Results: Frequent ED users comprised 3.5% of total ED patients, accounting for 14.3% of the ED visits. Significant factors associated with frequent ED use were: a regular source of care [odds ratio (OR), 2.79; 95% confidence interval (CI), 1.63 to 4.79], alcoholism (OR, 19.4; 95% CI, 3.84 to 98.0), high outpatient clinic use (OR, 2.66; 95% CI, 1.72 to 4.11), previous hospitalization (OR, 3.06; 95% CI, 1.94 to 4.82), chronic disease (OR, 3.07; 95% CI, 1.78 to 5.29), cancer (OR, 4.16; 95% CI, 1.29 to 13.4), gastrointestinal disease (OR, 6,28; 95% CI, 1.95 to 20.2), cardiovascular disease (OR, 8.41; 95% CI, 2.51 to 28.1), pulmonary disease (OR, 4.21; 95% CI, 1.04 to 17.1), low level of emergency (OR, 5.43; 95% CI, 3.40 to 8.68), and dissatisfaction with treatment outcome (OR, 2.62; 95% CI, 1.32 to 5.20). Conclusions. Frequent ED users were responsible for a disproportionate number of the total ED visits. Andersen's &quot;need factors&quot; were strongly associated with frequent ED use, while the investigated predisposing factors were not significant. Most patients who visited the ED had a low level of emergency. These findings suggest that implementation of an integrated delivery system may decrease ED use.
    關聯: OPHTHALMOLOGICA 217(5):358-364
    顯示於類別:[台中附設醫院] 期刊論文

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