高危險妊娠因素與出生體重對新生兒住院醫療費用的影響

The Influence of High-Risk Pregnancy Factors and Birth Weight on Newborn Inpatient Expenditure

楊雅淑(Ya-Shu Yang) ； 黃偉堯(Wei-Yao Huang)

《台灣公共衛生雜誌》 32卷3期 (2013/06) Pp. 240-250

https://doi.org/10.6288/TJPH2013-32-03-04

摘要

Objectives: The aim of this study is to investigate the influence of high-risk pregnancy factors and birth weight on newborn inpatient expenditure. Methods: The study design is that of a secondary cohort study. The subjects are admitted patients with ages of 28 days or less from the 2008 National Health Insurance Research Database. This study analyzed the influence of high-risk pregnancy factors and birth weight on newborn inpatient expenditure by t-test, ANOVA and multiple regression. Results: The multiple regression results showed that a maternal age of 35 years or more at delivery (β=0.078), alcohol consumption during pregnancy (β=1.004), diabetes mellitus (β=0.181), renal disease (β=0.761), lung disease (β=0.599), anemia (β=0.119), giving birth to three or more babies (β=0.323), undergoing prolonged labor (β=0.176), suffering from oligohydramnios or polyhydramnios (β=0.290), having meconium stained amniotic fluid (β=0.259), having a prolapsed cord (β=0.414), undergoing a caesarean section (β=0.308), having a gestational age of less than 37 weeks (β=0.354), having a birth weight of less than 1,500g (β=1.428) and having a birth weight of 1,500-2,499g (β=0.432) increases newborn inpatient expenditure significantly (p＜0.05). Conclusions: Certain risk conditions associated with highrisk pregnancies as well as low birth weight increase newborn inpatient expenditure. This study suggests that when the Bureau of National Health Insurance modifies the Taiwan Diagnosis- Related Groups classification framework of Newborns and Other Neonates with Conditions Originating in the Perinatal Period (MDC 15), they should take into consideration various risk conditions that are associated with high-risk pregnancy in addition to birth weight.

關鍵字

高危險妊娠因素 ； 出生體重 ； 住院醫療費用 ； 診斷關聯群

並列摘要

Objectives: The aim of this study is to investigate the influence of high-risk pregnancy factors and birth weight on newborn inpatient expenditure. Methods: The study design is that of a secondary cohort study. The subjects are admitted patients with ages of 28 days or less from the 2008 National Health Insurance Research Database. This study analyzed the influence of high-risk pregnancy factors and birth weight on newborn inpatient expenditure by t-test, ANOVA and multiple regression. Results: The multiple regression results showed that a maternal age of 35 years or more at delivery (β=0.078), alcohol consumption during pregnancy (β=1.004), diabetes mellitus (β=0.181), renal disease (β=0.761), lung disease (β=0.599), anemia (β=0.119), giving birth to three or more babies (β=0.323), undergoing prolonged labor (β=0.176), suffering from oligohydramnios or polyhydramnios (β=0.290), having meconium stained amniotic fluid (β=0.259), having a prolapsed cord (β=0.414), undergoing a caesarean section (β=0.308), having a gestational age of less than 37 weeks (β=0.354), having a birth weight of less than 1,500g (β=1.428) and having a birth weight of 1,500-2,499g (β=0.432) increases newborn inpatient expenditure significantly (p＜0.05). Conclusions: Certain risk conditions associated with highrisk pregnancies as well as low birth weight increase newborn inpatient expenditure. This study suggests that when the Bureau of National Health Insurance modifies the Taiwan Diagnosis- Related Groups classification framework of Newborns and Other Neonates with Conditions Originating in the Perinatal Period (MDC 15), they should take into consideration various risk conditions that are associated with high-risk pregnancy in addition to birth weight.

並列關鍵字

high-risk pregnancy factors ； birth weight ； inpatient expenditure ； diagnosis-related groups

參考文獻

許振東、湯美萍、吳恩婷(2003)。圖解小兒科學。台北=Taipei:藝軒=Yi-Hsient Publishing。

陳月枝譯、廖珍娟譯、高碧霞譯(1998)。小兒科護理學。台北=Taipei:華杏=Farseeing Publishing Group。

楊雅淑、黃偉堯()。

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