The Study of Age Group Specific Emergency Triage System – Mis-Triage, Modification, and Model Validation

Project: National Science and Technology CouncilNational Science and Technology Council Academic Grants

Project Details


The introduction of emergency department (ED) patient acuity and triage system is a worldwide phenomenon to overcome the growing needs of emergency care and to match the changes of attitude to health and diseases, medical seeking behaviors, and health care systems. After decades of implementation, the continuous improvements of the current triage system become an important health care issue due to changes of health policy and ED overcrowding. The purposes of such improvement are to ensure the justice of care, to improve patient safety, and to increase medical quality. Particularly, the efficiency of ED management will greatly affect the sustainability of the whole health care system under resource constraints. This study will utilize medical records during 2011-2016 from the emergency department of a medical center with the highest ED service volume in Taiwan. The patients will be classified according to patient’s age group into three groups including pediatric patients aged < 18 years old, general adult patients aged 18-65 years old, and the elderly patients aged >65 years old. A total of 80,821 ED patients from 25 chief complaints in high urgency category (Taiwan Triage & Acuity System; TTAS 1 or 2) and 30 chief complaints in low urgency category (TTAS 4 or 5) will be collected for the analyses. The level of TTAS, vital signs, and physician’s initial prescriptions of examinations and treatments will be used as factors and modifiers in the multiple logistic regression models. The objectives of this study are as follows: 1) To assess and analyze the characteristics of mis-triage cases according to age groups and chief complaints. 2) To develop modified triage models according to patient’s factors including age group and chief complaints. 3) To validate the modified triage models by using post-ED hospitalization and total medical expenses as the validity indicators. The findings of this study will clarify and modify the mis-triage issues of the current TTAS. The anticipated impacts of this study will include a) to improve clinical efficiency; b) to ensure care quality; and c) to prevent delay treatments. In addition, the results will provide valuable information for future developments of clinical pathways or decision rules. The study embraces both academic values and innovative contributions in practice.

Project IDs

Project ID:PF10408-0722
External Project ID:MOST104-2410-H182-028-MY2
Effective start/end date01/08/1531/07/16


  • Taiwan Triage and Acuity System
  • Mis-triage
  • Patient Safety
  • Emergency Department Management


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