台灣高科技醫療儀器之利用趨勢，1998-2001

The Trend of Utilizations of High-tech Medical Instruments in Taiwan, 1998-2001

蔡文正(Wen-Chen Tsai) ； 龔佩珍(Pei-Tseng Kung) ； 楊志良(Chih-Liang Yang) ； 江怡如(Yi-Ju Chiang)

《醫務管理期刊》 6卷4期 (2005/12) Pp. 446-460

摘要

目的：過去研究認為高科技醫療的進步與廣泛被使用是醫療費用上漲的因素之一。本研究探討台灣地區高科技醫療儀器現況，並分析全民健保給付之九項高科技醫療儀器利用情形。
方法：利用1998年～2001年全民健保資料庫之全國申報資料，分別以全國與六個健保分局轄區為單位進行分析，瞭解九項高科技醫療儀器之採用與利用情形。五項檢查功能之儀器包含電腦斷層攝影掃描儀(CT)、核磁共振斷層掃描儀(MRI)、放射線同位素檢查(RT)、心導管檢查、周邊血管檢查；四項治療用之設備包含體外高震波腎臟碎石機(ESWL)、放射性同位素治療設備、高能遠距治療設備、直線立體定位放射治療設備等共計九項。
結果：除體外高震波腎臟碎石術與放射線同位素治療外，其餘7項之醫療利用皆有逐年上升的趨勢。醫療利用量年平約成長率在檢查儀器方面以心導管檢查成長22.47%最大、次之為核磁共振斷層掃描儀18.43%、周邊血管檢查為7.66%、電腦斷層攝影掃描儀為3.37%、放射線同位素檢查為1.43%；治療方面以直線立體定位放射治療成長17.39%最大，次之為高能遠距治療設備治療5.92%、放射線同位素治療為－1.98%、體外高震波腎臟碎石機治療為-7.85%。每千人醫療利用率方面，心導管檢查、MRI與直線立體定位放射治療等三項之年平約成長率仍然大於16%以上。此九項高科技醫療支出佔2001年度總健保醫療支出比例為3.51%。
結論：台灣部分高科技醫療之利用呈現逐年快速成長的趨勢，部分高科技醫療之利用在健保政策之規範下有明顯下降趨勢。整體而言，高科技醫療之利用仍然呈現緩步上升。

關鍵字

高科技醫療利用 ； 高科技醫療設備 ； 醫療費用 ； 電腦斷層掃描 ； 核磁造影

並列摘要

Objectives: Many researches have found that high-tech medical instruments are one of the main factors for the rise of health care cost. This research investigated the current situations and utilization for the nine high-tech medical instruments or treatments that were defined by Department of Health after National Health Insurance (NHI) was implemented.
Method: This research used nationwide NHI dataset for the years 1998 to 2001 to analyze the introduction and utilizations of high-tech medical instruments and the six branches of BNHI were the observation units as well. There are total nine high-tech medical instruments analyzed in this study. Five high-tech medical instruments with diagnostic function are the following: computerized tomography (CT), magnetic resonance imaging (MRI), radioisotope diagnosis, cardiac catheterization, and perivasculary. Four high-tech medical instruments with treatment function are extracorporeal shock wave lithotripsy (ESWL), radioisotope therapy (RT), super voltage teleradiotherapy equipment, and radiosurgery.
Results: Except for ESWL and RT, the utilizations of other seven high-tech instruments tended to increase year after year. For the diagnostic high-tech medical instruments, cardiac catheterization had the highest annual utilization growth rate that was 22.47%. The second one was MRI with 18.43% annual utilization growth rate. The annual utilization growth rate for perivasculary, CT, and radioisotope diagnosis were 7.62%, 3.37% and 1.43% respectively. For the treatment high-tech medical instruments, radiosurgery had the highest annual utilization growth rate that was 17.39%. The second one was super voltage teleradiotherapy equipment with 5.92% annual utilization growth rate. The annual utilization growth rate for RT was -1.98% and the ESWL was -7.85%. Using the number of high-tech medical instrument utilization per thousand populations as the utilization rate, the annual growth of utilization rate for CT, MRI, and radiosurgery were greater than 16%. These nine high-tech medical instruments accounted for 3.51% of national health care expenditures in 2001.
Conclusion: Some high-tech medical instruments decreased gradually under the regulation of health care insurance policy. However, the utilization of other high-tech medical instruments still tended to increase rapidly year after year. In short, the utilizations of high-tech medical instruments were rising slowly in Taiwan.

並列關鍵字

High-tech medical utilization ； High-tech medical instruments ； Healthcare expenditure ； CT ； MRI

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