本研究為瞭解2002年至2005年臺灣醫療不良事故之盛行率，探討醫療不良事故於特約別與地區別的盛行狀況，並比較病人安全政策實施前後醫療不良事故之盛行狀況。本研究採次級資料分析方法，以健保資料庫之住院申報資料進行院內感染、用藥相關錯誤、手術不良事故等三項醫療不良事故案件的分析。
研究結果顯示，病人安全政策實施後醫療不良事故之盛行率(平均91.236% )皆比實施前(81.733%)高；院內感染於病人安全政策實施後之盛行率(平均48.44% )皆比實施前(49.973% )低；手術不良事件於於病人安全政策實施實施後之盛行率(平均9.38%)皆比實施前(8.252%)高；醫學中心於病人安全政策實施後，醫療不良事故之盛行率逐年降低，於實施後第二年時之盛行率比實施前低；北區於病人安全政策實施後，醫療不良事故之盛行率皆比實施前低。
我國病人安全相關政策的推行目的，在於減少醫療不良事故事件的發生，政策推行至今已屆滿五年，其執行效果並不一致，特別是有關用藥安全及手術錯誤等不良事件發生的防範仍待加強，建議提高健保同儕審查的把關機制，並加強醫療倫理之再教育，以確保民眾安全的就醫環境。 This study was to explore the prevalence of medical adverse incidents and the effect of patient safety policy to decrease these incidents. The data sources were from National Health Insurance Research Database. We select and adopt the data of year 2002 to 2005 for this study, and the mainly incidents of the research was aimed at nosocomial infection, medication error and adverse operation incidents
The results showed adverse medical incidents were increase when the patient safety policy was implemented. However, the prevalence of adverse medical incidents was year by year decrease on Medical Center , and the prevalence of adverse medical incidents were also decrease after policy in Northern Taiwan. The results illustrated the both prevalence of nosocomial infections and adverse operation incidents were diminished too ,especially on the third year after policy practice.
To prevent the adverse medical incidents is the main purpose of patient safety policy. None the less, the execute effect was disparity after policy five years. It’s particularly need to improvement on the prevention of medication error and adverse operation incidents. To strenghthen the audit of Health Insurance claim and Re-education of medical ethics for medical personnel were strongly recommended.
