比較我國老年人超長住院及非超長住院之差異

The Influential Factors between Long-Stay and Non-long-stay Elderly Inpatients in Taiwan

方詩琁(Shih-Shuan Fang) ； 方詩珺(Shih-Chun Fang) ； 王勝廣(Sheng-Kuang Wang) ； 高森永(Sen-Yeong Kao) ； 周稚傑(Chih-Chieh Chou)

《中華職業醫學雜誌》 19卷2期 (2012/04) Pp. 93-99

https://doi.org/10.30027/CJOM.201204.0004

摘要

研究目的：本研究目的在探討65歲以上老年住院患者在非超長與超長住院之間之差異，以及容易產生超長住院之一般疾病及慢性疾病。研究方法：65歲以上老年住院患者分成住院天數30以內以及超過30天兩組，做二項式以及多變項迴歸分析統計，分析性別、年齡等病人人口學特徵，就醫地區、醫院層級與醫院屬性，以及病人的過去疾病與醫療利用情形如門診疾病類別、就醫及處置金額等因子，擷取合於百分之九十五信賴區間之有意義的因子（p＜0.05），作勝算比的分析。結果：本研究結果顯示住院前一年之門診疾病中傳染病與寄生蟲病及其後其影響、精神疾患、神經系統之疾病（腦膜炎除外）、意外傷害及非意外傷害等四項最易造成高齡患者超長住院的結果（OR＞1.2）；而感覺器官疾病、骨骼肌肉系統及結締組織疾病、需要醫療服務之其他原因等三者較不易造成高齡患者超長住院（OR＜0.8）。慢性疾病方面除痛風及皮膚疾病外，皆易造成高齡患者超長住院，且其中前兩名分別是高血壓及癌症（OR＞2）。結論：比較高齡患者易造成超長住院的因子，住院前一年之門診疾病中傳染病與寄生蟲病及其後其影響、精神疾患、神經系統之疾病（腦膜炎除外）、意外傷害及非意外傷害等四項，慢性病中高血壓及癌症是影響超長住院天數的重要因素。

關鍵字

超長住院 ； 老年人

並列摘要

AIMS: To clarify which factors may associate with the inpatient elderly being long-stay or non-long-stay hospitalization.METHODS: We conduct a retrospective, cross sectional study with the use of the data of the elderly inpatients from the database of the Bureau of National Health Insurance, ROC between 2001 and 2005. Utilization data of long-stay elderly were compared to the non-long-stay elderly by binary and multi-variable regression analysis.RESULTS: Compared with non-long-stay elderly, some factors of the long-stay elderly were correlated with higher hospitalization (p＜0.05). Among general diseases in out-patient department before one year of hospitalization, infectious and parasitic diseases with their sequelae, mental disorder, diseases of the nervous system (without meningitis), and accidental and non-accidental injuries had higher odds ratio. Among chronic disease, all chronic disease had OR＞ 1 except gout and skin diseases.CONCLUSIONS: We concluded that the above factors were correlated with long-stay hospitalization in elderly. This information may important for the policy of the government of health insurance.

並列關鍵字

Elderly ； long-stay ； hospitalization