Assessment of Disaster Medical Responses with Utstein Template : Comparison between in The Great Hanshin Earthquake in Japan and in Chi-Chi Earthquake in Taiwan

在回顾日本阪神大地震和台湾集集地震资料的基础上，应用哥德堡和麦迪逊版本的Utstein模板对这两次地震的灾害严重程度和健康灾害严重程度进行量化，重点关注其初始阶段。用哥德堡版本模板计算的阪神大地震和集集地震各指标的平均值分别为：医学指标75：48，公共卫生指标34：17，对卫生保健系统的影响17：6，准备工作48：12，应对不力41：9。神户平均43.0分，集聚18.4分。用麦迪逊版模板计算的每一次地震各要素得分如下：协调控制3：2，医疗7：2，医疗/床位2：2，粗死亡率7：3，医院死亡率5：3，免疫0：0，传染病0：0，医护人员2：1，医疗设备/电子3：2，医疗用品、药品、疫苗1：1，心理社会5：5，急救2：1，防备/计划1：1，防备/搜救和急救1：1，防备/医院为4：2，失踪/被困为6：1，营养为0：0，水为7：6，水/分发为6：6，卫生为6：5，住房/衣物为5：4，食物为6：5，食物/分发为6：5，搜救为2：1，总和为87：59。造成这些结果的根本原因肯定是阪神大地震袭击了城市地区，集集地震袭击了农村地区。然而，可以指出以下原因：国家层面的反应更迅速，受灾地区紧急指挥部的建立更快，军队和警察直升机运送救援物资和伤员更顺畅；集集地震的防灾能力比阪神大地震更好。

Reviewing materials on the Great Hanshin Earthquake in Japan and Chi-Chi Earthquake in Taiwan, we applied Gothenburg and Madison versions of Utstein template to these earthquakes to quantify disaster severity and health disaster severity, focusing on their initial phase.The mean values of score for each indicator in the Great Hanshin Earthquake and in Chi-Chi Earthquake calculated with Gothenburg version template were as follows: 75:48 in medical indicators, 34:17 in public health indicators, 17:6 in impact on the health care system, 48:12 in preparedness, and 41:9 in deficiency in response, respectively. Their average value was 43.0 in Kobe and 18.4 in Chi-Chi. The score for each element in each earthquake calculated with Madison version template were as follows: 3:2 in Coordination-Control, 7:2 in Medical, 2:2 in Medical/Beds, 7:3 in Crude Mortality Rate, 5:3 in Hospital Mortality Rate, 0:0 in Immunization, 0:0 in Communicable Diseases, 2:1 in Health care providers, 3:2 in Health equipment/Electronics, 1:1 in Health supplies, Medicaments, Vaccines, 5:5 in Psychosocial, 2:1 in EMS, 1:1 in Preparedness/Plan, 1:1 in Preparedness/SAR & EMS, 4:2 in Preparedness/Hospital, 6:1 in Missing/Trapped, 0:0 in Nutrition, 7:6 in water, 6:6 in Water/distribution, 6:5 in Sanitation, 5:4 in Shelter/clothing, 6:5 in Food, 6:5 in Food/Distribution, 2:1 in Search & Rescue, and 87:59 in summation, respectively.These results show that the impact on health management was more serious in Kobe than in Chi-Chi. The primitive cause of these results must be that the Great Hanshin Earthquake hit urban areas and Chi-Chi Earthquake hit rural areas. The following causes, however, can be pointed out such as prompter response at national level, prompter establishment of emergency headquarters in affected regions, smoother transportation of relief goods and the wounded by army and police helicopters; better disaster preparedness in Chi-Chi Earthquake than in the Great Hanshin Earthquake.