回顧與探討次級資料適用之共病測量方法

A Review of claims-based Comorbidity Measures

朱育增(Yu-Tseng Chu) ； 吳肖琪(Shiao-Chi Wu)

《台灣公共衛生雜誌》 29卷1期 (2010/02) Pp. 8-21

https://doi.org/10.6288/TJPH2010-29-01-02

摘要

行政申報資料已成為醫療服務研究重要之資料來源，如何適當地應用次級資料測量共病成為一重要議題，本文目的為探討適用於次級資料之共病測量方法及其應用。回顧國外文獻後，選取5種方法，包括Deyo等、Romano等(D-M's)、D'Hoore等三種版本之Charlson Comorbidity Index (CCI)、以次級資料發展之Elixhauser、及以藥物處方情形發展之Chronic Disease Score。分4部分進行論述：不同共病測量方法之差異、不同方法比較之實証研究、測量共病之資料期間或來源、及改進共病測量方法。研究者必須對各方法發展之背景與定義有所瞭解，再就其研究選用相對較適當之測量或分析方法，本文並對後續研究者選擇時應考量之因素，歸納出以下幾點建議：依研究族群共病分佈情形、醫療照護結果，選擇較合適之共病測量方法；考量較合適之資料期間或來源；依研究族群樣本數及研究之需要，選擇較合適之分析方法；並可思考改進共病測量方法。

關鍵字

共病 ； 次級資料 ； 行政申報資料

並列摘要

Administrative databases are increasingly used in health service research, and one major issue focuses on how to measure comorbidity. The purpose of this article was to review comorbidity measures and their applications for use with administrative data. Five methods of measurement: Deyo's Charlson Comorbidity Index (CCI), D-M's CCI, D'Hoore's CCI, Elixhauser and Chronic Disease Score (CDS) were selected. Reports in the literature were categorized in 4 areas: 1) introduction of comorbidity measures; 2) comparison of the performance of comorbidity measures; 3) comparison of the performance of comorbidity measures using different data periods or sources; 4) improving the performance of comorbidity measures. There are four suggestions for future research: 1) Consider the distribution of comorbid conditions in the source population and healthcare outcomes when selecting different comorbidity measures. 2) Consider how to select the data periods or sources when using comorbidity measures. 3) Consider the size of population when creating the comorbidity variables. 4) Consider how to improve the performance of comorbidity measures.

並列關鍵字

comorbidity ； administrative data ； claim data

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