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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

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.

參考文獻


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周盈邑、董鈺琪(2019)。姙娠糖尿病篩檢策略之成本效果分析台灣公共衛生雜誌38(4),387-399。https://doi.org/10.6288%2fTJPH.201908_38(4).108012
呂詩章(2014)。高危險妊娠之新生兒的醫療資源耗用評估研究〔碩士論文,國立虎尾科技大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0028-2608201415124600

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