- 期刊
旗津地區癌症病患醫療資源使用情形之探討
Utilization of Medical Resources by Cancer Patients from the Chi-Ching District in Kaohsiung
摘要
目的：本研究目的在瞭解旗津地區癌症病人之醫療資源利用以及就醫行為，同時探討住院醫療費用影響之因素。方法：本文採取橫斷性研究方法，以1998年1月至2001年6月間三年半內設籍於旗津地區並診斷為癌症病患為研究對象。初級資料經由面對面問卷訪視取得，次級資料由健保局高屏分局提供住院醫療費用清單。結果：共計有278位癌症患者符合條件，訪視完成率為78.4%，扣除33份無效問卷以及15位同時罹患兩種癌症者後，實際上共計170位癌症病人納入分析，存活個案86人、死亡個案84人。癌症部位分佈，以消化器及腹膜部位癌症病患的人數最多，共有70人(41.2%)，而在所有特定器官癌症中以肝癌的比例最高（33人，19.4%）。高達93.5%樣本曾至區域級以上醫院治療，且固定在同一家醫院就醫之比例達到78.8%。除西醫外，中醫治療是最常利用之醫療資源。癌症病患平均總住院醫療費用為167366元、每次住院醫療費用為67901元。複迴歸分析結果在控制相關人口學變項之後發現，住院日數、住院次數、存活狀況以及醫院層級這四個變項與住院醫療費用間有統計上之顯著相關。結論：旗津地區癌症患者以肝癌占多數，多數患者選擇固定在同一家醫院就醫，額外選擇中醫治療情形較為常見，可能影響住院醫療費用的因素包括住院日數、住院次數、存活狀況以及醫院層級，但在研究中並無法取得病人疾病嚴重度資料，故推論應保守。
並列摘要
Objectives: To study the pattern of medical visits by cancer patients in a southern town in Taiwan at the time of investigation. Methods: This is a cross sectional study of data collected from cancer patients living in the Chi-Jin area. They were admitted to nine hospitals, between January 1, 1998, and June 30, 2001. Primary data were collected from interviews with patients or their family members. Secondary data were obtained from the database of these patients stored in the Kao-Pin Branch of the Bureau of National Health Insurance, located in a major southern city of Taiwan. Results: There were 278 cancer patients and 78.4% responded to the interview (The remainders are presumed expired.). Excluding 33 questionnaires that were incomplete and 15 patients who had more than one type of cancer simultaneously, there were 170 cases to be analyzed (86 alive & 84 death). Malignant neoplasms of the digestive tract had the highest percentage, 41.2%, with the liver as the site most frequently involved (n=33, 19.4%). There are 93.5% subjects ever used medical cares in the regional hospitals and medical centers. We also founded there were 78.8% patients fixed in one hospital. Chinese medicine treatment was the common untraditional medical resource utilization among cancer patients (38.2%). The averaged total hospitalized medical fees was 167,366 and the fees in each hospitalize for the study subjects was NT$ 67,902. After multiple regression analysis adjusted other demography variables, we found that hospitalized days, hospitalized times, survival status, and hospital levels have statistically significant with hospitalized medical fees. Conclusions: Liver cancer patients were most frequency in Chi-Ching District. Cancer patients usually fixed in one hospital and Chinese medicine treatment was the common untraditional medical resource utilization. However a long-term, follow up study will be needed for a more accurate assessment.