女性應力性尿失禁患者之門診醫療利用及費用分析

Medical Utilization and Costs of Outpatient Visits in Women with Stress Urinary Incontinence

李若屏(Jo-Ping Lee) ； 陳建勳(Chien-Hsun Chen) ； 吳英黛(Ying-Tai Wu) ； 洪秀娟(Hsiuo-Chuan Hung) ； 曹昭懿(Jau-Yih Tsauo)

《物理治療》 31卷2期 (2006/04) Pp. 112-117

摘要

目的：本研究在探討民國89和90年台灣地區應力性尿失禁女性患者之門診利用與醫療花費情形。方法：分別由全民健康保險學術研究資料庫所提供的健保申報資料之門診抽樣檔及復健特定檔找出應力性尿失禁女性患者（國際疾病分類號為625.6），分析並比較89和90年的門診就醫人次及利用率、年齡分佈、就診科別及費用。結果：由門診抽樣性資料發現就醫之應力性尿失禁婦女以31-65歲的比例最高。門診就診科別為婦產科、泌尿科及外科，抽樣資料中並無接受復健治療者。由抽樣檔所得之病患，外科診治之病患平均每人次門診醫療費用約為600元，在泌尿科約為1500元，婦產科病患之花費由89年882元增加為90年3566元；而復健特定檔分析所得之資料，平均每人次之門診醫療費用，約700至1300元。且90年接受復健治療之人次低於89年。其中由婦產科申報復健治療者最多，佔60.0％，90年由復健科申報者比例提高（38.4%增為57.8%）。結論：兩年中應力性尿失禁女性接受復健治療者比例不到1%，建議物理治療師應多加宣導保守療法之療效，並增加與婦產科、泌尿科醫師的合作。

關鍵字

尿失禁 ； 物理治療 ； 復健治療

並列摘要

Background and Purpose: This study aimed to investigate the medical utilization and cost of women with stress urinary incontinence (SUI) from outpatient clinics during the years of 2000 and 2001. Methods: A nationwide data released from Bureau of National Health Insurance and National Health Research Institute were analyzed. We extracted data from the files of Ambulatory Care Expenditures by Visits (CD files), Details of Ambulatory Care Orders (OO files), and Rehabilitation Service (RH files) to get medical utilization data of women with SUI (ICD-9-CM coded as 625.6), including age, usage rate, the registered departments and the cost in the years of 2000 and 2001. The CD and OO files were systematically sampled from the total claimed data, with a rate of 0.5%, while the RH files included all the claimed data from department of rehabilitation. Results: From the data bank of ambulatory care, the majority of cases receiving the treatment were women aged between 30 to 65 in 2000 (66.67%) and 2001 (76.28%). None of them had rehabilitation therapy. Departments of gynecology, urology and surgery were the three primary caring departments. The average outpatient costs per case from the surgery department was about NTD 600, NTD 1500 for patient from urology department, and NTD 882 and 3566 from gynecology department in year of 2000 and 2001 respectively. From the data of RH files, the average outpatient costs per case from rehabilitation department was NTD 700-1300. The total number of cases receiving rehabilitation service decreased from 2000-2001. Gynecological departments reported the highest rate of prescribing the rehabilitation services (60.0%), however, rehabilitation departments had utilization rate increased from 38.4% to 57.8% in these two years. Conclusion: Less than 1% of the cases with diagnosis of SUI utilized rehabilitation services. We suggested physical therapists made more intensive cooperation with all the relevant physicians in addition to physiatrists to benefit the patients with SUI most.

並列關鍵字

Incontinence ； Physical therapy ； Rehabilitation