| 摘要: | 研究背景：
為探討海上到院前傷病事件影響其存活狀況之因素，綜觀過去研究，發現有顯著影響之變項包含年齡、國籍、所在區域或距岸距離、所在船舶、擔任職級、工作部門及傷病種類等因素，而我國現行由海巡署執行海上傷病患後送。
研究方法：
為了解商船及漁船向政府機關求援之概況，因此本研究以海巡署資料建置數據庫，進行回顧性研究，使用獨立樣本t檢定、卡方檢定，或Fisher’s精確檢定檢驗存活狀況之顯著關係，再使用邏吉斯迴歸作為檢驗各變項與存活狀況之間是否具有顯著關係。
研究結果：
傷病患之年齡越大，其死亡機會越高；案件後送距離越遠，其死亡機會越大；在我國執行之案件中，漁船死亡之勝算小於商船；傷病患之擔任職級、工作部門及傷病類型在部分檢定效果中有顯著，可能受其他因素影響結果；性別及是否為我國籍並未發現顯著影響。
研究結論：
非我國籍傷病患超過六成；高齡傷病患死亡機率更高；距岸距離拉長將導致存活機會下降；工作部門有顯著結果，但受遺漏值影響；商船之死亡勝算較漁船高，原因可能存在於本研究變項外；遠距後送案件占用海巡署處置是類案件之大部分人力及時間資源。
研究建議：
建議依年齡縮短健康檢查頻率，以篩選高風險族群；建立海上救護收費標準，以有效利用社會資源；推動修法建立海上救護體系，並設置海上EMS指導醫師；訂定海上救護紀錄表及應用系統，並鏈結消防機關救護紀錄系統及健保資料庫，據以發展海上職業安全及傷害防治研究領域。
Backgrounds:
To explore the factors that affect the survival status of pre-hospital injuries and illnesses at sea, this study reviewed past studies that have found the variables which have significant variables include age, nationality, distance, ship type, rank, department, and type of injury or illness. In Taiwan, R.O.C. Coast Guard Administration currently implements medical evacuation of patients at sea.
Methods:
To understand the general situation of merchant and fishing ships seeking assistance from government agencies, this study is a retrospective study based on the data from R.O.C. Coast Guard Administration. In this study, independent sample t-Test, Chi-square test, or Fisher’s Exact Test were used to test the significant relationship between survival status. Logistic Regression was used to test whether there is a significant relationship between each variable and survival status.
Results:
Results show that the older patient has a higher chance of death. The farther evacuated distance has a higher chance of death. The odds of death at fishing ships are less than the odds of death at merchant ships. The rank, department, and type of injury or illness of patients are significant in Chi-square test or Logistic Regression and may be affected by other factors. No significant effect was found on gender and whether they are Taiwanese.
Conclusions:
More than 60% of the wounded and sick patients of non-Taiwanese nationality. The risk of death is higher for elderly patients. The longer the distance from the shore will lead to a decrease in the chance of survival. The work department is discovered significant results but is affected by missing values. Merchant ships have a higher odds of death than fishing ships, and the reason may lie outside the variables of this research. Long-distance MEDEVAC cases occupy most of the manpower and time resources of R.O.C. Coast Guard Administration to handle such cases.
Recommendations:
This Research recommend to shorten the frequency of health examination according to age to filter high-risk groups. Establish maritime EMS charge standards to effectively utilize social resources. Promote amendments to establish a maritime EMS, and set up maritime Medical Direction implementation. Formulate the maritime rescue record form and application system, and link fire-fighting authorities rescue record system and NHIRD to develop maritime occupational health, injury prevention and control research fields. |
