健保就醫資料看青光眼病人的就診習慣―初報

The Utilization of National Health Insurance Resource for Reviewing the Clinical Visit Choice of Glaucoma Patients in Taiwan-Preliminary Report

顏永昌(Yung-Chang Yen) ； 高建中(Chien-Chung Kao) ； 蔡武甫(Wu-Fu Tsai)

《中華民國眼科醫學會雜誌》 44卷3期 (2005/09) Pp. 132-137

https://doi.org/10.30048/ACTASOS.200509.0004

摘要

目的：探討全民健康保險就診病人中被診斷為青光眼的比率及其就診習慣，以作為公共衛生對視力保健宣導工作之依據，及改善對青光眼患者之照護方式。
方法：以國家衛生研究院和中央健康保險局合作所建立之「全民健康保險研究資料庫」，以隨機方式抽樣五萬人，再由1996-1999年之全部全民健康保險就診記錄中，將這五萬人其四年之完整就診記錄取出，再用統計程式SPSS 8.0 for windows版，卡方檢定做統計分項分次分析其內容。
結果：由1996~1999年之資料分析可知因青光眼而接受治療之人數為全部人口之0.38%，有逐年增加之趨勢，其中六十至八十歲就醫之比率為所有年齡層人口最高(0.98%)。依就診次數之統計，一年中因青光眼就診，平均為每年4次，以每年1-2次為最多，占54%；六十至八十歲病人就診次數較多，平均每年5次。以青光眼為診斷的就診中，以六十至八十歲占所有就診次數的62%為最多。季節上之變化，在青光眼人數上無明顯差異，在就診次數上之差異也不明顯。依醫學中心、區域醫院、地區醫院及基層院所的就診次數觀察，可見說診習慣已有逐年向基層院所就診的趨勢。
結論：由各國所評估出之青光眼發生率來推斷，台灣青光眼患者之就診率只有三分之一，比英國研究之四分之三未就診率（四分之一就診）雖有領先，但仍有努力之空間。

並列摘要

Background: The percentage of outpatients of National Health Insurance who had a diagnosis of glaucoma was investigated herein, and also was the choice of the medical organizations for the clinic visit. The investigation was to advocate vision care for public health and to revise care policies for glaucoma patients.
Methods: 50,000 random samples were selected from the National Health Insurance Research Database established by the National Health Insurance and the Bureau of National Health. The complete clinical visit record of these 50,000 patients from 1996-1999 were analyzed by chi-square test according to SPSS 8.0 for Windows after stratified by patient's age, the accredittation status of hospital, season of the year and the frequency of follow up per year.
Results: The prevalence of glaucoma among these patients was 0.38% and the prevalence increased annually. The highest prevalence of glaucoma (0.98%) was in the patients with the age of 60-80 years. The annual frequency of the clinical visits for glaucoma was 1-2 times per year for 54% of the cases; more frequent in those cases aged 60-80 years (5 times per year). Sixty two percent of the glaucoma-caused clinical visits occurred in the patients with the age of 60-80 years. Seasons had no significant influence on the number of the glaucoma patients and the frequency of clinical visits for glaucoma. The medical organizations in Taiwan were ranked into 4 by government which are medical centers, district hospitals, local hospitals, and the basic organizations. Before 1997 over half of the clinical visits for glaucoma occurred in higher ranked organizations but after 1998 the condition changed significantly, more visits for glaucoma in basic organizations.
Conclusions: The prevalence of glaucoma from these data was 0.38%, which constituted only about 1/3 of the reported prevalence of glaucoma in Taiwan. This figure meant that 2/3 of our glaucoma patients had not been treated yet. Our public health care still have much to do in the future!

並列關鍵字

Glaucoma ； National Health Insurance ； Resource utilization