| 摘要: | 背景：人口結構老化是全世界的趨勢。台灣人口結構的老化指數高居亞
洲第二位，僅次於日本。人口結構的變化關係到國家各項政策方向及未來社
會資源的分配。過去在離島地區因為地理阻隔，青壯年人口多因就業就學而
外移，老年人口則因安土重遷之觀念而留守家園。但在最近幾年間因為政治
與經濟環境的改變，如兩岸政治對立情勢的趨緩、金門馬祖小三通政策及離
島開發博弈專區的等議題，影響到台灣離島地區的人口數目及結構。國家為
帄等照顧當地居民的健康與解決急重症醫療資源缺乏問題，採取的政策包括
提升在地醫療水準與建立空中醫療轉診制度。台灣地區的空中醫療轉診制度
自2002 年10 月貣由台北醫學大學傷害防治學研究所提出研究計畫，建立新
制空中轉診業務及成立救災救護單一窗口，由專科醫師全天候進駐輪值，在
申請、評估、判斷及派遣執行上均有良好成效，又使用即時同步之遠距視訊，
使需要空中轉診之病人，可立即執行，不需空中轉診的病人則繼續追蹤治療。
本研究係一系列空中轉診研究之一，主要目的在探討台灣空中轉診病患年齡
結構變化的趨勢並比較與當地人口年齡結構的相關性，以作為相關公共衛生
政策之參考。
方法：本研究為回溯性分析研究，以2003 年1 月至2010 年12 月間台
灣地 區經由空中轉診審核中心核准轉診的案件為研究對象，以微軟EXCEL
2010 年版及 PASW 18.0 版為研究工具。
結果：
自民國92 年1 月1 日至民國99 年12 月31 日，共計八年期間，行政院衛
生署空中轉診審核中心接獲台灣離島及偏遠地區申請空中緊急醫療之諮詢審核
案件共計2,540 件，其中通過審核轉送的病患人數共計2,218 名，總核准率為
84.75% (2,218/2,540)。空中轉診至本島就醫的病患帄均年齡為50.3 歲，年齡最
小0 歲(新生兒)、年齡最大102 歲；其中男性有1,504 位( 67.8%, 帄均年齡為
50.4±24.7 歲)、女性714 位(32.2%, 帄均年齡為 50.1±24.8 歲)。男女帄均年齡雖
均為50 歲，但其疾病分類不同，男性非外傷及外傷比例為2.1：1；女性非外傷
及外傷比例為2.7：1。
由研究資料顯示，台灣離島及偏遠地區經空中緊急醫療轉送病患的帄均年
齡由47.1 歲上升到53.7 歲，增加了14.2%。老年病患轉診比例由32.5%上升到
40.5%，增加了24%；但是主要離島地區老年人口數的增加僅為10.1%，所佔人
口比例更呈負成長3.6%。台灣離島空中醫療轉診人口的老化比較當地人口的老
化程度更加明顯。從各年度的轉診年齡變化與年齡分層統計更可見在70 歲以上
的病人呈現逐年增加的趨勢且增加的速度較其他年齡層顯著。70 歲以上空中轉
診病人中以心臟科病人最多，佔30.8%（204 / 662）。
結論與建議：離島地區因醫療資源不足，急重病病患必頇使用有風險性的
空中轉送方式返台就醫，對於當地民眾而言一直是希望改善的議題，空中醫療
轉診人口的人數增加與老化，其代表當地老年人口帄均壽命的增加與民眾對於醫療結果的期待提升，故遇到急重症情形，希望盡可能回到台灣醫學中心得到
最好的照顧，面臨老化海嘯的來臨，如何做好預防醫學，提升離島地區在地醫
療品質，建立離島民眾接受在地醫療的信心仍是政府與醫界頇共同努力的議題。
本研究限於研究範圍，僅就空中轉診年齡結構及趨勢作探討，關於其轉送的效
益是否恰當，如空中轉診病患轉診後三日內出院、自動出院或死亡的情形，有待進一步的資料收集與後續分析。
Background: The aging population is a worldwide trend. Taiwan's aging population structure index ranks second in Asia after Japan. Because of geographical barriers, the younger people of remote island used to move to urban area for work or study and the elderly population stayed in homeland. However, political and economic issues, such as cross-strait political confrontation situation has slowed down, the small three links policy in Kinmen and Matsu islands, and developmental proposal of the game area in Penghu, the population structure of remote islnads of Taiwan changed substantially. For taking care of the need of emergency and critical patient in remote island, the government of Taiwan established aeromedical transport system. In October 2002, the Taipei Medical University, Institute of Injury Prevention and Control proposed to establish the new system for the effcient and verification purpose. The main purpose of this study was to explore the Taiwan aeromedically transported patients in the age structure and trends
Methods: This is a retrospective analysis of aeromedically transported cases approved by NAAC in Taiwan from January 2003 to December 2010. Microsoft EXCEL 2010 edition and PASW 18.0 version were used as statiscical research tool.
Results:
During the 8-year period, there were 2,540 cases consulted for aeromedical transport purpose and 2,218 cases were approved. The total approved rate is 84.75% (2,218 / 2,540). Air transfer to Taiwan for medical treatment of patients with an average age of 50.3 years, the youngest aged 0 (newborn) and the oldest patient aged 102 years old; The major part of patient is male ( 1504 cases, 67.8%, the average age was 50.4 ± 24.7 years; female cases: 714, 32.2%, mean age 50.1 ± 24.8 years). In the stratification analysis of age group of transferred patinet revealed most prominent increased numbers of patient in the age group above 70 years of age.
During the study period, the average age of aeromedically transported patient rose from 47.1 years to 53.7 years, an increase of 14.2%. The proportion of air transferred elderly patients increased from 32.5% to 40.5 %, an increase of 24%.However, the increased number of elderly population is only 10.1%, and percentage of elder people even reduced 3.6%.
Due to lack of adequate medical resources, emergent and critical patients need an air transfer means to return to Taiwan for furtehr treatment. the number of air medical referral increased with the aging population, with representatives of local average life expectancy of the elderly population increases and the public expectations for improved medical outcomes.Facing the coming tsunami of aging and demanding of critical medical care, how to enhance the quality of medical care in offshore islands, espcially in the emergent and critical care is still the issue for the government and the medical community . |
