住院病人的泌尿系統感染症研究

A Study on Inpatients with Urinary Tract Infections

廖國毅(Kuo-Yi Liao) ； 廖佩珊(Pei-San Liao)

《中華民國血液淨化醫學會雜誌》 10卷1期 (2005/01) Pp. 7-12

https://doi.org/10.30024/JFBPS.200501.0002

摘要

由於細菌性泌尿系統感染症是民眾住院的重要原因之一，且過去國內罕見這方面的流行病學文獻，本研究之結果將有助於實醫學研究之發展。
本研究係利用國家衛生研究院提供的全民健保研究資料庫，1997年西醫住院醫療之系統比例抽樣檔中，主診斷欄位爲泌尿系統感染症的記錄進行統計分析，目的在於評估國內因泌尿系統感染症住院病患的流行病學指標與資源耗用情況。
研究中以總住院日數及住院醫療費用為資源耗用的代表。過程中以統計套裝軟體爲工具，利用描述性探討罹病者的流行病學特徵以及資源耗用的實況。研究主要結果列示如下：
1.整體而言，女性病患占約七成。六歲以下的學齡前幼兒卻是男性較多。
2.除學齡前期之外，其發生的頻率隨著年齡層增加呈上升的趨勢。
3.醫療費用與住院日數的分佈均呈現不對稱而高度右偏的情況，且二者的變異係數都相當大。
4.依穩健估計法可得病患的平均年齡為48.73歲（標準誤為0.49）、平均住院日數為6.0天（標準誤為0.04），平均住院醫療費用為每人次9095.5元（標準誤為89.06）。
由前述的結果推論：1997年國內細菌性泌尿系統感染症住病患的流病指標與國外往昔的情況相近。但後續仍需進行其他年度的相關研究，方能確定這類疾病在國內的發生趨勢與耗費資源的確實狀況。

關鍵字

醫療費用 ； 住院日數 ； 穩健估計

並列摘要

Infections are one of the most common diseases that require hospitalization of an individual and urinary tract infections (UTIs) rank the second among them. It is important to learn the epidemiologic characteristics and medical resource utilizations due to UTIs in our country but such informations were insufficient. In order to fulfill the aforementioned purpose, we did a study based on health insurance claim databases available through National Health Research Institute (NHRI).
From the data set for the year 1997, we extracted those records where ICD (international classification of disease) coding of their major diagnoses were UTIs. We analyzed them using commercial statistical programs. Our main findings included:
1. Overall, there is a clear female preponderance that accounted for seventy percent of the cases. However, male dominance is seen in the group of preschool age.
2. UTIs happened in increased frequency with increasing age, except for the preschool age group.
3. Distribution of both medical expenditures and length of hospital stay (LOS) were asymmetrical and skewed to the right with a heavy tail. Their coefficients of variance were quite large.
4. According to robust estimation, the average age of these patients was 48.73±0.04 years, their average LOS was 6.0±0.04 days and the average expenditure was 909.5±89.06 Taiwan Dollars.
From those results, we conclude that epidemiologic details of UTIs in Taiwan were not much different from those in other countries. However, we suggest that analyzing similar data sets of different years is mandatory to obtain a full understanding of their thends of occurrence and resource utilization in Taiwan.