- 期刊
食道癌病人醫療資源耗用分析
The Medical Resources Utilization of the Esophageal Cancer Patients
摘要
目的：本研究旨在探討食道癌病人分別在不同病人特質、癌症分期、病灶處與治療情形下其醫療資源耗用情形。材料與方法：本研究採立意取樣(Purposive sampling)之方式，個案為2000年4月1日至2004年12月31日於南部某醫學中心胃腸內科確診為食道癌之病人，資料蒐集由二方面著手，使用結構式病歷表格與食道癌病人住院費用明細檔，經個案篩選後，共計86名食道癌病人。結果：在醫療資源耗用部分，住院次數以有復發者較無復發者增加0.82次(p≦0.05)；住院日數方面其癌症分期第Ⅵ期者較第Ⅰ期者增加29.76日，病灶處為食道中段者其住院日數較食道上段者減少21.23日，治療方式上以單一化療者或放療者之住院日數最低，較外科手術減少25.29日，達(p≦0.05)；初次住院費用在61歲以上者其費用較50歲以下者減少166,425元，癌症分期為第Ⅱ與Ⅵ期者較第Ⅰ期者分別增加254,852元與280,517元(p≦0.05)；總醫療費用其初診年齡為61歲以上者其費用較50歲以下者減少178,084元，癌症分期為第Ⅵ者其費用較第Ⅰ期者增加295,221元，病灶處於食道中段者其總醫療費用較食道上段者減少195,540元，化學放射療法和單一化療或放療其總醫療費用均低於外科手術(p≦0.05)。結論：病人特質、癌症分期、病灶處與治療情形是影響醫療資源耗用之因子。
並列摘要
Purpose: The main purpose of this study is to explore the medical resources utilization among esophageal cancer patient in different patient characteristics, Tumor Node Metastasis (TNM) stage, location, and treatment condition. Methods: This is a purposive sampling study. The case from April 1st, 2000 to December 31st, 2004 in one medical center. The Data conducted from two parts, one was collected from standardize chart review form; other inpatient data. The study has 86 case after select. Result: A part of medical utilization, the frequency of disease recurrence for inpatient was 0.82 more than non-recurrence (p≦0.05); the stage Ⅵ of the inpatient days was 29.76 more than the stage Ⅰ, the middle of the location was 21.23 less than the upper, chemotherapy and radiotherapy of the treatment were 25.29 less than the surgery (p≦0.05); the first inpatient fees for over 61 years old was NT $166,425 less than under 50, the stage Ⅱ and Ⅳ of the first inpatient fees were NT $254,852 and NT$ 280,517 more than the stage Ⅰ (p≦0.05), respectively; the total fees for over 61 years old was NT$ 178,084 less than under 50, the total fees for the stage Ⅳ was NT$ 295,221 less than the stage Ⅰ, the middle of the location was NT$ 195,540 less than the upper, CCRT and chemotherapy or radiotherapy were less than surgery (p≦0.05). Conclusion: Generally, the patient characteristics, TNM stage, location, and treatment condition were effective factors of medical resources utilization.