以全民健康保險研究資料庫探討臺灣慢性C型肝炎患者之抗病毒藥物治療之利用

Utilization Analysis of Anti-HCV Treatment in Taiwanese with Chronic Hepatitis C Using National Health Insurance Research Database

楊菀婷(Wan-Ting Yang) ； 賴美淑(Mei-Shu Lai) ； 高嘉宏(Jia-Horng Kao)

《台灣醫學》 20卷2期 (2016/03) Pp. 124-133

https://doi.org/10.6320/FJM.2016.20(2).2

摘要

本研究之目的在於使用國家衛生研究院之全民健康保險研究資料庫分析臺灣慢性C型肝炎患者接受抗病毒藥物治療之利用分析，並預估未來之疾病負擔。從資料庫中篩選於西元2004-2010年間曾經被診斷為慢性C型肝炎感染患者，估算其盛行率約為1.28-1.66%，本研究發現臺灣尚未接受C型肝炎抗病毒藥物治療之患者達13萬人，這些病患多為女性、高齡(＞70歲)、未定期接受超音波追蹤檢查、非肝膽腸胃科追蹤、在區域醫院及地區醫院接受照護、於東部就醫以及曾接受洗腎、合併腦中風或食道靜脈曲張者。未接受C型肝炎抗病毒藥物治療患者將因病程惡化而造成更大的社會及醫療負擔，因此針對具上述特徵患者制定公共衛生政策以提升其就醫警覺性與C型肝炎治療率為將來努力之目標。

關鍵字

慢性C型肝炎 ； C型肝炎抗病毒藥物 ； 藥物利用分析 ； 共病症與合併症 ； 疾病負擔

並列摘要

In this study, we aimed to explore several important issues regarding chronic hepatitis C (CHC) infection in Taiwan by using the National Health Insurance Research Database. We also performed utility analyses for CHC patients receiving anti-HCV therapy and estimated disease burden of CHC in Taiwan. The enrolled patients were chosen from 2004 to 2010 with the diagnosis of CHC and the corresponding prevalence rate was 1.28-1.66%. On the basis of our data, around 130,000 CHC patients remained untreated. The characteristics of untreated patients included female gender, age above 70 years, without regular abdominal ultrasonography examination, follow-up at district hospitals or primary clinics, living in eastern part of Taiwan, or having dialysis, cerebrovascular accident or esophageal varices. These patients who did not receive anti-HCV therapy may have disease progression and thus increase the future disease burden. To solve this emerging issue, we should improve the disease awareness of CHC patients and encourage them to receive anti-viral therapy earlier.

並列關鍵字

chronic hepatitis C virus ； anti-HCV treatment ； drug utilization ； comorbidities and complications ； disease burden

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