以台灣健保資料庫探討醫事人員與急性循環系統疾病相關性研究

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Title:	以台灣健保資料庫探討醫事人員與急性循環系統疾病相關性研究 A Cohort Study on Acute Circulatory Diseases among Medical Personnel Using the National Health Insurance Research Database
Authors:	王翠儀
Contributors:	職業安全衛生系鄭天浚
Keywords:	急性循環系統疾病醫事人員健保資料庫過勞 medical personnel National Health Insurance Research Database in Taiwan acute circulatory diseases ,burnout
Date:	2014
Issue Date:	2015-10-26 20:24:16 (UTC+8)
Abstract:	文獻顯示，長期的工作壓力會引發急性循環系統疾病。台灣醫療環境逐年改變，醫護人員人力分布不均，許多人面臨工作時間過長、精神緊張；再加上輪班制度，致使醫事人員長期存在工作壓力。是否成為急性循環系統疾病之高風險族群，值得研究。本研究使用全民健保資料庫的2000年百萬歸人檔進行回溯性世代追蹤研究，以2000年醫事人員為暴露組，選取性別、年齡配對的對照組，比較二組間罹患急性循環系統疾病的發生率。研究結果發現，醫事人員急性循環系統疾病住院發生率比對照組低，風險比為0.75，達顯著差異(p=0.003)。醫師急性循環系統疾病危險比較低，風險比為0.70 (p=0.005)。以年齡分層後，35～50歲之醫師的風險比為0.64 (p=0.035)，小於35歲之醫師(風險比=0.73)與大於50歲之醫師(風險比=0.77)急性循環系統疾病之發生率與對照組並無顯著差異(p>0.05)。其他各醫事人員與對照組則無顯著差異（護理人員風險比=0.81、藥師風險比=0.73、其他醫事人員風險比=0.94，皆為p>0.05）。雖然醫事人員具備有較正確、完備的醫療知識且有較規律的服藥習慣，具有較良好的自我照顧，但面臨高工作壓力、長工時及輪班工作仍具有相當程度之風險。因此未來醫療院所健康照護人員進行職場健康促進時，壓力紓解、慢性病之預防、治療，都是刻不容緩之議題。 Long-term overload from work could facilitate the development of circulatory diseases, including cardiovascular and cerebrovascular diseases. In the past several decades, the working environment of healthcare worker in Taiwan changed gradually. Due to the uneven distribution of manpower, many healthcare workers face long working hours and high working stress. Together with those, shift work makes medical personnel in Taiwan as a high-risk group for circulatory diseases.Data of one million subjects were obtained from a random population sample from the National Health Insurance Research Databaseas as a representative sample from 2000. We conducted a retrospective cohort study to assess the risk of acute circulatory diseases among medical personnels in Taiwan. Medical personnels were compared to controls matched by sex and age. We assessed the incidence of hospitalization due to acute circulatory diseases among groups using logistic regressions. We found that medical personnels in Taiwan had a lower risk of hospitalization due to acute circulatory diseases compared to the general population (hazard ratio [HR] = 0.75, p = 0.003). After stratification by professional categories, the HR among physicians was 0.70 (p = 0.005). After stratification by age, the HR among physicians aged between 35 to 50 years was 0.64 (p=0.035), while the HR among physicians aged below 35 years (p=0.73) or above 50 years (p=0.77). The differences did not reach statistical significance. None of the HRs in other medical personnels reached statistical significance (HR in nurses =0.81, HR in pharmacists = 0.73, HR in other medical personnels = 0.94; p > 0.05 in all groups).Although medical personnels have a more correct, complete medical knowledge with better self-care ability, still have a significant risk in facing high work pressure, long working hours and shift work. Therefore, workplace health promotion of health care personnels in hospitals to relieve pressure, prevent and treat chronic disease is mandntory.
Relation:	網際網路公開：2016-06-26，學年度：102，151頁
Appears in Collections:	[Dept. of Occupational Safety] Dissertations and Theses

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