The longitudinal Trends in the Utilization and Population Dose of Medical Radiological Procedures in Taiwan

台灣放射醫學診療使用率與集體劑量的長期趨勢

洪茂欽(Mao-Chin Hung)

《慈濟技術學院學報》 22期 (2014/03) Pp. 47-62

摘要

本研究分析台灣放射醫學診療使用率與集體劑量的長期趨勢，數據取自全民健康保險研究資料庫1997年至2009年間的放射醫學就醫紀錄。利用描述性統計分析放射醫學診療使用率、集體有效劑量、年齡與性別分佈情形，以線性迴歸分析使用率與集體有效劑量的長期趨勢，並採用Pearson相關分析法分析影響使用率的相關因子。結果發現，1997至2009年間平均每年放射醫學診療量為17,919,102次，約為每千人792次，總放射醫學使用量隨時間顯著增加，年增量為每千人39.3次。胸腔X光攝影是最常進行、也是成長最快的檢查項目，平均每年每千人234.9次，佔總診療量的29.6%，並以每年每千人11.3次增加。此外，台灣每年接受放射醫學診療的集體有效劑量約為12,639人西弗以每年759人西弗增加，相當於每人0.58毫西弗，從1997年的0.37毫西弗增加至2009年的0.78毫西弗，其中以電腦斷層掃描貢獻最多，佔總集體劑量的45.3%，增加也最為快速，以每年380人西弗增加。整體而言，台灣放射醫學診療的使用率及集體劑量在這13年間有明顯的變化，一般X光攝影、電腦斷層掃描、乳房攝影及大部分介入性透視攝影顯著增加，而傳統透視攝影則有減少的趨勢。此外，除了上肢攝影、頭顱攝影、膀胱攝影與子宮輸卵管攝影外，大部分放射診療實施於40歲以上的中老年人，因此放射診療量的增加趨勢應與人口年齡老化有密切的關係。

關鍵字

放射醫學診療 ； 集體有效劑量 ； 長期趨勢 ； 全民健康保險研究資料庫

並列摘要

Purpose: The objective of this study is to determine the levels and trends of various medical radiological procedures within National Health Insurance (NHI) system in Taiwan, as well as the corresponding collective effective dose during 1997-2009. Materials and Methods: The medical radiological records were extracted from the National Health Insurance Research Database (NHIRD) between 1997 and 2009. Description statistics was applied to analyze the frequencies and distributions of medical radiological practices. Linear regression analysis was adopted to assay the longitudinal trend in the utilization and population dose. Pearson's correlation analysis was used to analyze the factors correlating the utilization of radiological procedures. Results: Approximately 792 medical radiological procedures were performed per thousand population in Taiwan annually during the period of 1997-2009, with 39.3 annual increment from 543 to 1,049 per 1,000 population. Chest radiographic examinations were performed most frequently and increased most rapidly, accounted for 29.6% of all procedures with 11.3 annual increment per 1,000 population. The annual population dose from all the radiological practices was estimated to be 12,639 man Sv or 0.58 mSv per capita with 759 man Sv increment annually. Computed tomography (CT) contributed mostly to the collective effective dose, accounted for 45.3% of the total exposures with most significantly increase about 380 man Sv annually. Totally, the utilization and population dose of all radiography, CT scan, mammography, and most interventional fluoroscopy increased significantly; On the contrary, the utility and population dose of conventional fluoroscopy were in downward trends. Except cystography, hysterosalpingography, upper extremities and skull radiography, most medical radiological practices were performed in subjects more than 40 years of age. Conclusion: The medical radiological exposure in Taiwan has increased considerably in the past 13 years. The trend may be correlated closely with aging of the population.

並列關鍵字

medical radiological procedures ； population dose ； longitudinal trend ； National Health Insurance Research Database (NHIRD)