急診壅塞的問題一直困擾著全世界的許多國家，它不僅造成病患的醫療救治
結果變差，更將低醫院急診室的醫療品質。在全民健保制度的落實之下不但降低
醫療費用支出，更調降人民的就醫門檻，這使輕、重症的病患都能選擇往急診室
求診，使整體的處置時間延長。
醫院急診室主要針對急重症患者在有限的時間下進行即時處置而設立。在醫
療人力資源有限下，過多非急重症患者前往急診室就醫，不僅容易影響急重症患
者的救治結果，更可能讓急診室的醫護人力過度負荷，導致人才流失。本研究使
用2000 年及2005 年全民健保資料庫百萬人次抽樣檔，以心肌梗塞、出血性中風
及阻塞性中風等重症患者作為研究對象，採用羅吉斯迴歸模型探討急診室輕症患
者的人流多寡是否會影響急重症患者的救治結果，特別是在醫學中心層級。另外
台灣經常遇上週末與夜間門診休診的狀況，使輕症患者只能選擇前往急診室求診，
我們加入時間要素，觀察在週末以及夜間時段下，是否急診輕症壅塞對於急重症
患者的醫療救治結果有顯著的影響存在。根據實證結果，整體來看急重症患者的
醫療結果受到輕症患者就診率影響並沒有達到統計上的顯著性，特定週末時段與
夜間時段中結果都未明顯對急重症患者的醫療結果有顯著的影響。

Emergency department congestion can causes poor medical treatment outcomes for
patients worldwide. In addition, it reduces the quality of medical treatment in the
emergency room. The implementation of the National Health Insurance System in 1995
in Taiwan lowered medical expenses and the threshold for people to seek medical
treatment. It means that high number of patients with mild symptoms can be present in
the emergency department, which increases waiting times for all. The emergency room
is available for patients with acute and severe symptoms. It is designed to use the limited
time for treatment. However, too many non-emergency patients can delay the treatment
time of emergency patients and worsen their condition when medical resources are
limited. In addition, medical staff can be overworked, which leads to a shortage of
medical talent in the emergency department. This study used the National Health
Insurance Database from 2000–2005 to assess the effect of the number of patients with
mild symptoms on emergency patient outcomes in medical centers. We included patients
with myocardial infarction, hemorrhagic stroke, and obstructive stroke. Most patients
with mild symptoms choose to visit the emergency department during the weekend and
night periods; therefore, we evaluated whether treatment outcomes were affected by
emergency department congestion during these periods. Interestingly, we found no
significant effect of mild patient numbers on the treatment outcomes of patients with
severe disease, including during the weekend and night periods. In summary, there was
no effect the number of non-emergent patients on the treatment outcome of severe
patients.

中文部分
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2. 江旺財、李衛華、廖之倩(2015)，「台灣急診壅塞的初探」，輔仁醫學期
刊，13(4)，223-231。
3. 吳士良(2007)，「急症病患週末假日入院與死亡風險及其住院天數的關
係」，國立陽明大學醫務管理研究所碩士論文。
4. 李淑芬、林宜靜、蔡偉德(2012)，「醫療救治品質存在週末效應？」，人
文及社會科學集刊，24(2)，233-275。
5. 林志豪(2018)，「日夜溫差大，小心腦中風」，林自豪醫師，民97 年12
月20 日，取自：https://drneurolin.com/。
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取自：http://www.fma.org.tw/2011/S-24-5.html。
7. 胡勝川(2015)，「如何因應急診壅塞」，財團法人台灣醫療改革基金會，
民104 年5 月18 日，取自：http://issue.thrf.org.tw/index.asp。
8. 張文瀚、黃謙瑄、蔡正河(2006)，「急診室之檢傷病患於尖離峰時刻就
醫之時間探討」，中華民國急救加護醫學會雜誌，18(1)，21-30。
9. 許錦田(2009)，「冬季腦中風」，高醫醫訊月刊，29(6)，4-6。
10. 黃柏諭(2013)，「運用系統模擬最佳化探討動態急診部資源規劃之研
究」，東海大學工業工程與經營資訊學系碩士論文。
11. 鄒永駿(2017)，「醫師人力與醫療結果之分析—以週末及夜間急診為
例」，國立中央大學產業經濟研究所碩士論文。
12. 蔡光超(2019)，「論醫院評鑑制度在解決急診壅塞現象時可扮演之角色」，國立台灣大學社會科學院政治學系政府與公共事務碩士在職專班
碩士論文研究計畫書。
13. 蔡哲福、蔡哲宏、李怡慶、謝良博、黃子齡(2013)，「急診檢傷分類等
候制度與病人知覺等候時間之相關性研究-以某區域教學醫院為例」，
澄清醫護管理雜誌，9(4)，20-28。

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相關網站
1. 台灣急診醫學會 https://www.sem.org.tw/
2. 財團法人醫療改革基金會 https://www.thrf.org.tw/
3. 衛生福利部 https://www.mohw.gov.tw/mp-1.htm