台灣阿茲海默症病人確診前的門診醫療利用

The Utilization of Ambulatory Care Services before the Diagnosis of Alzheimer's Disease in Taiwan

蔡維河(Wer-Her Tsai) ； 侯素秋(Shu-Chu Hou) ； 黎家銘(Chia-Ming Li) ； 楊清泉(Ching-Chyune Yang)

《台灣公共衛生雜誌》 30卷4期 (2011/08) Pp. 316-325

https://doi.org/10.6288/TJPH2011-30-04-02

摘要

目標：本研究旨在探討台灣阿茲海默症病人確診前3年內的門診醫療利用，及與非阿茲海默症病患間是否存在顯著差異。方法：採用1996至2007年國家衛生研究院2005年全民健康保險承保抽樣歸人檔資料，採用隨機對照研究，篩選用藥明細首次出現阿茲海默症用藥（乙醯膽鹼酶抑制劑與NMDA受體拮抗劑）之確診病人共845人為病例組，另經性別、年齡、查爾森共病指數等匹配隨機選取1,677人為對照組，比較確診前三年兩組個案同期門診醫療利用的差異。結果：阿茲海默症病人確診前的門診醫療利用明顯高於對照組。阿茲海默症病人確診前1年的總門診次數及神經精神科門診次數，診察費、藥費、處置費、及總費用等4項費用，均較對照組高，且均達統計顯著差異水準。其中，阿茲海默症病人確診前3年期間的藥費，均顯著較對照組為高。結論：台灣阿茲海默病人確診前門診醫療利用，高於非阿茲海默症個案。

關鍵字

阿茲海默症 ； 門診醫療利用 ； 病例對照研究 ； 全民健保研究資料庫

並列摘要

Objectives: The aim of this study was to assess if the rate of ambulatory care utilization within three years before the diagnosis of Alzheimer's disease was significantly different from that of non-Alzheimer's patients. Methods: The data were drawn from the National Health Insurance Research Database from 1996 to 2007. A case-control design was employed. A total of 845 patients treated with Alzheimer's disease medications (cholinesterase inhibitors and NMDA receptor antagonists) were the case group. Another 1,677 patients who were randomly matched by age, sex, and Charlson index served as the control group. Ambulatory care utilization by the case group within three consecutive years before diagnosis was explored and compared to that of the control group. Results: Alzheimer's disease patients used significantly more ambulatory care services (neurology and psychiatry clinics, diagnostic fees, drug fees, treatment fees) than did the control group within the first year before diagnosis. Drug fees within the three consecutive years before diagnosis were significantly higher than those of the control group. Conclusions: Patients with Alzheimer's disease patients used significantly more ambulatory care services than did non-Alzheimer's patients before that diagnosis was made.

並列關鍵字

Alzheimer's disease ； ambulatory care utilization ； case-control study ； National health insurance reseach database

參考文獻

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