勞工職業病與職業傷害醫療資源耗用探討

Study of Labor Occupational Disease and Occupational Injury Medical Resource Spending

嚴玉華(Yu-Hua Yan) ； 許碩芬(Shuo-Fen Hsu) ； 方世杰(Shih-Chieh Fang) ； 龔志銘(Chih-Ming Kung) ； 牟聯瑞(Lein-Ray Mo)

《中華職業醫學雜誌》 16卷3期 (2009/07) Pp. 183-192

https://doi.org/10.30027/CJOM.200907.0003

摘要

目的：本研究利用全民健康保險資料庫，所提供完整職業病與職業傷害資料進行分析，以瞭解台灣地區職業病與職業傷害的長期醫療費用變動趨勢。
材料與方法：以國家衛生研究院提供之全民健康保險研究資料民國91年至95年職業病與職業傷害門病患為研究對象，進行台灣地區勞工職業病與職業傷害分佈的特性及變動趨勢，及針對病患年齡、住院日數、診斷類別、健保各分區及各縣市進行醫療費用平均數及佔率等描述性統計。
結果：顯示從92年開始職業傷病的醫療費用，呈現逐年增加的現象，而其門診及住院醫療費用在健保醫療點數所佔的比率，也從91年的千分之3.6增加至95年的千分之4.3，且每件平均醫療費用均有上升的趨勢。另在年齡的族群耗用以壯年居高，男性居多，且就醫疾病集中在外傷性的診斷，如骨折、燒傷、顱內損傷等；就醫的醫療機構中，以醫學中心和區域醫院佔率最高，中小型醫療院所的比率最少；病患就醫的縣市則是以桃園縣最高。
結論：本研究為國內首度利用完整的門診及住院的健保職業傷病資料，其結果可提供勞方、資方、政府及醫療院所，對勞工安全與健康及預防職業傷病長期投資與關心。

關鍵字

職業病 ； 職業傷害 ； 醫療費用

並列摘要

Objectives: the study used the database of the National Health Insurance to obtain and analyze the complete data of occupational diseases and occupational injuries, so that the long term trends of occupational diseases and occupational injuries in Taiwan may be defined.
Methods: descriptive statistics was performed on the National Health Insurance research data regarding occupational disease and occupational injury patient subjects from 2002 to 2006 provided by the National Health Research Institutes to analyze occupational disease and occupational injury distribution features, trends, patient age, hospitalized duration, diagnostic category, average medical expenses in each district and county/city for the health insurance and the coverage rate in Taiwan.
Results: the medical expenses on occupational diseases and injuries have showed gradual increasing trends since 2003; the outpatient and hospitalizing expenses presented higher ratio among health insurance points, from 3.6 per 1000 in 2002 to 4.3 per 1000 in 2006. Also, an increasing trend on the average medical expenses per case was observed. On the aspect of age and gender, the expense was higher for adult males; the common diseases and injuries included traumatic events, such as bone fractures, burns and internal cranial injuries. On the aspect of medical organization, most cases were found in medical centers and regional hospitals; while the least cases were found in small- to middle-sized hospitals. Most patients were found in Taoyuan County.
Conclusion: this is the first study that used the complete health insurance data on outpatient and hospitalized occupational events in Taiwan. The results may provide labor, management, governmental and medical treatment centers with long-term investment and interest regarding labor safety, health, occupational disease and injury prevention.

並列關鍵字

occupational diseases ； occupational injury ； insurance cost