身心障礙者合併多發性硬化症患者住院醫療利用與醫療資源耗用

Long Term Trend in Inpatient Care and Medical Expenditure of the Disabled Comorbid with Multiple Sclerosis

李培瑄(Pei-Hsuan Lee) ； 林金定(Jin-Ding Lin)

《身心障礙研究季刊》 11卷4期 (2013/12) Pp. 210-219

摘要

目的：本研究主要目的乃探討多發性硬化症患者住院醫療利用上的情形與資源、耗用情形趨勢。方法：本研究採用次級資料，利用2001－2005年全民健康保險資料庫住院醫療費用清單明細檔（DD檔）進行分析。研究對象為領有身心障礙手冊且ICD-9-CM診斷碼為340之住院多發性硬化症病患，以SPSS20.0版進行相關統計分析。結果：本研究多發性硬化症患者住院基本人口學特性分析資料，研究對象中以女性佔大多數，女性約為男性的三倍；平均年齡男性約為39－42歲，女性約為42－45歲；總醫療費用每人一年平均花費為132609.7－171101.5元；住院就醫權屬別以財團法人醫院為最多（佔39.7－42.5%），其次為私立醫院（14.1－18.1%）和榮民醫院（9.4－15.3%）、公立醫學院附設醫院（9.6－12.6%）、私立醫學院附設醫院（5.7－8.4%）。結論：台灣多發性硬化症住院病患中主要是以女性為主，在住院醫療費用方面發現，主要是以醫療費用占大多數，其他復健治療費用、診察費、病房費，隨著年度增加並無太大的變化，醫療費用的變化可能因為多發性硬化症病患住院者病情皆較嚴重、或是有疾病復發、合併症的因素導致醫療費用較高的現象。值得注意的是，住院病患通常為疾病嚴重程度較重的病患，因為身體功能障礙，憂鬱症也為多發性硬化症病患常見的合併症之一，不僅會影響其日常生活品質並增加患者罹患其他疾病的風險，是未來值得研究進一步之方向。

關鍵字

住院醫療利用 ； 罕見疾病 ； 多發性硬化症 ； 醫療資源耗用

並列摘要

Objective: The purposes of this study were to analyze national data to understand the long term inpatient medical utilization and medical expenditure in the disabledcomorbid with multiple sclerosis. Methods: The study used 2001-2005 National Health Insurance database, to select the main diagnosed disease was multiple sclerosis (ICD-9-CM: 340) among people with disabilities in the analyses. Result: The result showed that the hospitalizedpatients with multiple sclerosis, women weremore prevalentthan men (three times).The male average age was 39-42 years old, for female were 42-45 years old, and the total medical cost was 132609.7-171101.5 NT dollars/per. In the hospital level of medical care utilization, most of patients were more likely to use private corporate hospitals than other kinds of hospital. Conclusion: In this study, we found that women used more inpatient care than men. Medical treatment expenses were the main expenditure of the medical spending in recent years,otherexpenses such as rehabilitation, medical examination, and ward fees were not changing in the study period. The medical cost rise may cause by the serious of disease, disease relapse or other comorbidity of the patients. The study highlights that those hospitalized patients were more likely to be serious ill and needed to pay much attentions to their conditions in the future research.

並列關鍵字

Inpatient utilization ； medical care expenditure ； multiple sclerosis ； rare disease

參考文獻

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