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多發性硬化症患者門診利用與醫療資源耗用長期趨勢初探
Long-term Trends in Outpatient Care and Medical Expenditure of Patients with Multiple Sclerosis
摘要
目的：本研究主要目的乃分析多發性硬化症患者在門診醫療利用與醫療資源耗用的長期趨勢。方法：本研究使用2001－2005年全民健保資料庫中門診處方及治療明細檔（CD），針對領有身心障礙手冊的民眾，選取主診斷確診為多發性硬化症之病患（ICD-9-CM：340），利用SPSS 20.0版進行相關統計分析。結果：研究結果顯示，女性較容易罹患多發性硬化症，女性人數約為男性的三倍，平均年齡集中於40－45歲；在就醫層級別方面，多發性硬化症病患就醫地點以財團法人醫院為最多（佔26.4－34.7%），其次為榮民醫院（佔11.3－14.9）及公立醫學院附設醫院（11.5－14.9%）、私立醫學院附設醫院（8.3－10.2%）、診所（6.0－8.7%）；就診科別以神經科為最多（佔57.2－62.1%），其次依序為復健科（佔11.3－15.2%）、中醫科（佔4.1－8.2%）、內科（佔1.9－3.6%）。結論：治療多發性硬化症不管在藥品、總醫療費用等費用上都呈現上升的趨勢，但經由曲線估計檢定的結果可以發現，患者人數並沒有明顯增加的趨勢，但在費用上、就醫權屬別及就診科別的人數上卻有明顯增加的現象，因此探討其中造成醫療費用增加的主要原因，並且提升對於罕見疾病病患的照護，成為未來研究的方向及改善的目標。
並列摘要
Objective: The purpose of this study was to analyze national data to understand the outpatient medical utilization and medical expenditure in patients with multiple sclerosis. Methods: The study used 2001-2005 National Health Insurance database, to select the main diagnosed disease was multiple sclerosis (ICD-9-CM: 340) among people with disabilities in the analyses. Result: The result showed that the number of multiple sclerosis patient, women was three times more than men. In the hospital level of medical care utilization, most of patients were more likely to use private corporate hospitals than other kinds of hospital. With regard to the treat departments, the results showed that most of the patient treated in the neurological department, the next was in the rehabilitation department, and traditional Chinese medicine department. Conclusion: In this study, we found that there were increasing trend in medical expenditure among patients with multiple sclerosis. We suggest the future study should exam carefully of the main reasons of this increasing trend and to improve quality of medical care for this vulnerable population as well.