台灣2006－2008年0－19歲兒童傷害住院特性及醫療費用

Characteristics and Medical Expenditures of Children Aged0-19 Hospitalized for Injuries in Taiwan, 2006-2008

游斯雯(Si-Wen Yu) ； 白璐(Lu Pai) ； 林金定(Jin-Ding Lin) ； 簡戊鑑(Wu-Chien Chien)

《醫護科技期刊》 14卷1期 (2012/03) Pp. 29-43

https://doi.org/10.6563/TJHS.2012.14(1).3

摘要

目的：瞭解台灣19歲以下兒童傷患住院特性並探討住院醫療費用之影響因子。方法：使用2006－2008年全民健保資料，串連「住院醫療費用清單明細檔（DD）」、「醫事機構基本資料檔（HOSB）」及「重大傷病證明明細檔（HV）」，選取N Code中主診斷或任一次診斷為800－999傷害個案，並以SPSS 18.0進行分析。結果：台灣2006－2008年計有142,287件19歲以下兒童傷害住院，3年總住院醫療費用為新台幣53.3億元。傷患年齡以15－19歲比例較高（40%），具有重大傷病的比例佔3%，就醫層級以區域醫院為主（45.8%），大多在中度都市化市鎮就醫（47.1%），傷害類型以骨折比例較高（34.3%），傷害原因多為交通事故（46.2%），而傷患只有1種傷害比例較高（64.7%），但有5.4%的傷患高達5種傷害。以多變項羅吉斯迴歸分析，兒童住院傷患醫療費用的影響因子有性別、年齡、重大傷病、就醫醫院層級、都市化程度、傷害類型、傷害原因及複合性傷害數。結論：骨折及交通事故為兒童最常見傷害類型及原因，溺水住院醫療費用最高，往後應預防兒童交通傷害所致骨折，並降低溺水醫療費用。

關鍵字

傷害 ； 兒童 ； 全民健保資料庫 ； 醫療費用

並列摘要

Purposes: This study examined the characteristics of injured children aged 0-19 in Taiwan and factors associated with hospitalization medical expenditures. Methods: This research used SPSS 18.0 software to study ”inpatient expenditures by admissions (DD)”, ”registry for contracted medical facilities (HOSB)” and ”catastrophic illness (HV)” data from the National Health Insurance Research Database between 2006 and 2008. We defined injury cases as patients identified by ICD-9-CM N Code ”800-999”. Results: A total of 142,287 injury cases among children aged 0-19 were registered during the 3-year 2006-2008 period. Medical expenditures associated with this group totaled NT5.33 billion. Those in the 15-19 age bracket accounted for the highest proportion of admissions (40.0%); A total of 3% of the group held a catastrophic illness card; Regional hospitals received the highest percentage of admissions (45.8%); Nearly half (47.1%) of patients were from urban areas; Fractures represented the largest (34.3%) injury category; Nearly half (46.2%) of injuries were associated with traffic accidents; and most patients (64.7%) were single injury cases. Factors associated with injury-related hospital medical expenditures included gender, age, catastrophic illness card, hospital type, urban demographic, injury type, injury cause and multiple injury status. Conclusions: The most common types and causes of injury included fractures and traffic accidents. Drowning was associated with the highest medical expenditure burden. To reduce overall expenditures, authorities should develop prevention strategies to reduce fractures caused by traffic injuries and strategies to reduce drowning-related medical expenditures.

並列關鍵字

Injury ； child ； National Health Insurance database ； medical expenditure

參考文獻

林佳欣、白璐、高森永、簡戊鑑(2010)。台灣地區 2005-2007 年意外溺水死亡及住院者特性分析。醫護科技期刊。12(4)，280-289。

賴文彬、嚴元隆、王建楠、蘇世斌(2008)。台灣南部某醫院急診溺水個案 13 例之臨床分析。台灣家醫誌。18(1)，29-40。

簡戊鑑,白璐,朱基銘,高森永,蔡行瀚 S. H., S. H.(2010).Trends in child and adolescent injury mortality in Taiwan, 1986-2006.臺灣衛誌.29(1),22-32.

行政院法務部 (2010)‧全國法規資料庫- 兒童及少年福利法‧線上檢索日期：2010 年 3 月 12 日‧ 網址： http://law.moj.gov.tw/fr.asp [Ministry of Justice, Executive Yuan. (2010). Laws & regulation database of the Republic of China-child and young welfare method. Retrieved Retrieved March 12, 2010, from http://law.moj.gov.tw/fr.asp]

行政院衛生署 (2010)‧ 97 年度國民醫療保健支出‧線上檢索日期：2010 年 5 月 12 日。網址：http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=10947&level_no=2&doc_no=74048 [Department of Health, Executive Yuan. (2010). National health expenditure, 1998. Retrieved May 12, 2010, from http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=10947&level_no=2&doc_no=74048]