從健保透析申報資料定義並分析國內慢性腎衰竭病患透析情形

Definition and Analysis of Patients with Chronic Dialysis from the National Health Insurance Database

吳肖琪(Shiao-Chi Wu) ； 黃麟珠(Lee-Gyu Haung) ； 雷秀麗(Hsiu-li Lei) ； 吳義勇(Yee-Yung Ng)

《台灣公共衛生雜誌》 23卷5期 (2004/10) Pp. 419-427

https://doi.org/10.6288/TJPH2004-23-05-10

摘要

目標：國內外有不同定義慢性透析的方式，本研究嘗試以健保透析申報資料，找出較佳的定義，並探討國內慢性透析盛行及發生情形。方法：利用88年加密之「門診處方醫令明細檔」中透析醫令與「門診處方及治療明細檔」、「全民健保承保人口資料檔」、「全國戶政資料檔」、及87、88年「死亡檔」等串檔後進行分析。依單月透析次數超過10次、曾在門診透析或有接受腎臟移植者、連續透析4個月、連續接受透析3個月(不管次數)、連續接受透析3個月且每個月超過4次、連續接受透析3個月且每個月超過8次及連續接受透析3個月且每個月超過10次等不同條件來定義；以列聯表呈現不同定義之差異，並計算透析盛行率及發生率。結果：慢性透析病患條件的界定以連續透析4個月(即連續透析超過3個月)或連續透析超過3個月且每月超過4次選取較佳，88年底整體慢性透析盛行率為13.0人／每萬人口、全年發生率為3.4人／每萬人口，且女性透析盛行率及發生率高於男性，以65～74歲盛行率最高。結論：未來可從健保透析申報資料，以連續透析4個月或連續透析3個月每月超過4次來作為慢性透析病患之定義。

關鍵字

透析 ； 腎病 ； 健保 ； 盛行率

並列摘要

Objectives: There are several different definitions of patients with chronic dialysis in Taiwan and abroad. The purpose of this study was to find a better definition of patients with chronic dialysis from the claimed data of National Health Insurance. Methods: The 1999 national health insurance inpatient and outpatient medical benefit claim databases were linked with the 1998 and 1999 death files for the purposes of analysis in this study. The different definitions of patients with chronic dialysis were listed as below: dialysis treatments over 10 times per month, receiving dialysis treatment or renal transplantation, dialysis continuously over 4 months, dialysis continuously over 3 months, dialysis continuously for 3 months and over 4 times dialysis treatments per month, dialysis continuously for 3 months and over 8 times dialysis treatments per month, dialysis continuously for 3 months and over 10 times dialysis treatments per month. We used the contingency table method to compare different definitions. The prevalence and incidence rates of chronic dialysis were also described. Results: The best definition of patients with chronic dialysis was dialysis was a continuous 4 month or continuous 3 months span of time with over 4 times dialysis treatments per month. According to this defintion, the prevalence rate of chronic dialysis in 1999 was 13.0 per 10,000 population, and the incidence rate was 3.4 per 10,000 population. The distribution for prevalence and incidence by sex showed that females have a higher rate of dialysis treatment. Incidence and prevalence rates tended to increase with age, but the prevalence rate fell for the oldest age group. The largest group of prevalent patients fell between the ages of 65 to 74 years. Conclusion: We suggest that future studies related to dialysis studies could adopt the definition of receiving dialysis continuously for 4 months or continuously for 3 months at over 4 times per month from the claimed data of National Health Insurance.

並列關鍵字

dialysis ； renal disease ； health insurance ； prevalence

參考文獻

(2003)。中華民國89年台閩地區現住人口數。內政部。

(2002)。中華民國台灣地區八十九年全民健康保險統計年報。行政院衛生署。

(2000)。中華民國89年台閩地區身心障礙者生活需求調查報告。內政部。

(2002)。行政院衛生署。台北:行政院衛生署。

Binder H,Eng G.(1989).Rehabilitation Management of Children with Spastic Diplegic Cerebral Palsy.Arch Phys Med Rehabil.70,482-489.