台灣老年人口醫療利用與多重慢性疾病之分析研究

Medical Utilization and Comorbidity among Aging Population in Taiwan

宋文娟(Wen-Chuan Sung) ； 洪錦墩(Chin-Tun Hung) ； 陳文意(Wen-Yi Chen)

《臺灣老人保健學刊》 4卷2期 (2008/12) Pp. 75-87

https://doi.org/10.29797/TJGHR.200812.0001

摘要

人口老化將帶來社會上醫療衛生福利服務問題，台灣老化問題日益嚴重，透過實證量化的分析，了解老年人罹患多重疾病情形將有助於醫療衛生主管機關擬定未來老人醫療照護之相關計畫與政策以提供老人健康照護上之需求。本研究以國家衛生研究院提供之2003年「全民健保學術研究資料庫」20萬名樣本為研究分析對象，其中選取65歲以上老年人口分析其所罹患前十大疾病，並排除急症及一般理學檢查，進行多重疾病狀況分析。發現65歲以上老年人在西醫門診醫療利用次數上平均達24.2次；在住院次數上，所有老人平均住院次數為1.7次，前五大罹患疾病分別為自發性高血壓、骨關節病、白內障、功能性消化疾病及糖尿病等。若以罹病老人無其他併發症比率來看，以胃炎及十二指腸炎的87.19%最高，糖尿病15.44%最低，以罹患糖尿病再罹患其他多重疾病機率最高。在老人罹患疾病盛行率的前十大疾病中，又以罹患糖尿病的老人之多重疾病項目為最多，最高可同時合併8種以上之其他疾病；其次為高血壓性心臟病之合併症則有7種、其他慢性缺血性心臟病則有6種，可見多重疾病問題在老人健康問題上是相當重要，特別是糖尿病疾病。在老人疾病盛行率之前前三大疾病，均有接近5成之病患合併1-2項之其他疾病，因此多重疾病問題在老人是相當普遍現象。因應年齡結構老化，社會的疾病負擔愈重，特別是老年疾病，時常合併多種疾病，造成家庭或社會的負擔，也讓年長者受到多重病痛，就老人健康之醫療政策而言，建議台灣應及早發展老人醫學專科，除可減少老人多重疾病就醫次數所帶來時間與醫療資源耗用外，也可提升老人多重疾病處方與用藥安全。

關鍵字

老年人 ； 多重疾病 ； 醫療利用

並列摘要

The population aged 65 and over in Taiwan has grown rapidly. The aging of the population will have profound impacts on health care. The purpose of this study was to exam the comorbidity of Taiwan's elderly through empirical, quantitative analysis. This study analyzed the database of National Health Insurance on comorbidity of people age 65 and over. Comorbidity for people age 65 and over: The three most commonly reported conditions were high blood pressure, cataracts, and diabetes. For those with high blood pressure, 55.09% had one or two, 5.5% had three or four, and 0.09% had five and more comorbid conditions. For those with cataracts, 73.37% had one or two, 6.5% had three or four, and 0.03% had five and more comorbid diseases. For those with diabetes, 59.17% had one or two, 21.29% had three or four, and 4.10% had five and more comorbid conditions. The health care professionals should pay more attention to health promotion and prevention services for the elderly. In addition, it is important to promote the integration of the health system.

並列關鍵字

Elderly ； comorbidity ； utilization