老年人於全民健康保險中醫門診醫療服務之利用分析

Service Utilizations of Traditional Chinese Medicine among the Elderly: Data from the National Health Insurance in Taiwan

洪錦墩(Chin-Tun Hung) ； 郭慈安(Tsu-Ann Kuo) ； 李卓倫(Jwo-Leun Lee) ； 陳文意(Wen-Yi Chen) ； 黃光華(Kuang-Hua Huang) ； 施雅文(Ya-Wen Shih)

《臺灣老人保健學刊》 6卷2期 (2010/12) Pp. 136-157

https://doi.org/10.29797/TJGHR.201012.0002

摘要

背景與目的：臺灣地區的人口結構迅速老化，瞭解老年人的醫療需求趨勢是健保重要議題，慢性疾病及癌症等難以治癒疾病增加，中醫醫療服務是許多老年人就醫的另一選擇；本研究目的在探討全民健保中65歲以上老年人利用中醫醫療之情形。方法：研究使用全民健康保險學術研究資料庫2005年中醫醫療資料庫進行相關分析，資料以醫事機構基本資料檔、醫事人員基本資料檔、中醫門診處方及治療明細檔及承保資料檔來進行串檔，並篩選出有利用中醫醫療服務65歲以上老年人共2,788,508位作為研究對象，利用SPSS 12.0進行分析，研究將描述老年人在中醫門診就醫之人口學特性、疾病類型與就醫醫療機構等情形，再以迴歸模型分析影響65歲以上老年就醫者之中醫門診醫療費用因素。結果：65歲以上的老年人利用中醫門診，女性佔53.78%高於男性；單一年齡別以65歲的老年人醫療利用佔率較高佔8.20%；年齡愈高，中醫醫療利用人次愈低；65歲以上老年人平均每人每年利用次數為1.26次，以臺中市利用次數最高為2.19次；在中醫醫療利用常見的疾病較高者為急性鼻咽炎（感冒）佔7.38%，其次為咳嗽7.08%、依次分別為腰痛3.83%、頭痛3.66%、便秘2.91%；以迴歸分析的結果發現在性別、年齡、投保金額、投保分局別、中醫疾病診斷與給藥日數皆會影響到老年人的中醫醫療費用。結論：老年人健保中醫醫療利用中，地區醫療供給量明顯影響中醫醫療利用量及費用。中醫門診服務成為部分老年人日常感冒等一般疾病或損傷疾病之重要選擇，是否因慢性病的利用尚無特別明顯的結果呈現。

關鍵字

老年人 ； 中醫醫療 ； 全民健康保險 ； 醫療服務利用 ； 臺灣

並列摘要

Background and Purpose: The rapid increase of the aging population and how it affects different types of health services is an important issue for future planning of the National Health Insurance in Taiwan. In addition to Western medicine, using traditional Chinese medicine to treat chronic illnesses or cancer is a common health service option. Therefore, the purpose of this study was to examine service utilizations of traditional Chinese medicine among people 65 years and older in Taiwan. Methodology: Based on the 2005 National Health Insurance data and using SPSS 12.0 as a tool for statistical analysis, this study analyzed service utilization patterns in usage of traditional Chinese medicine among people 65 years and older. The relationships among demographic characteristics, disease codes, and service utilizations were examined and a regression analysis was performed to find the factors affecting the usage of traditional Chinese medicine. Results: There are a total of 2,788,508 elder. The average utilization rate was 1.26 per month, with Tai-Chung City having the highest rate of 2.19. The most frequently used services in traditional Chinese medicine were for acute respiratory condition (7.28%), coughing (7.08%), lower back pain (3.83%), headaches (3.66%), and constipation (2.91%). In general, older women opted for the usage of traditional Chinese medicine more than older men; and utilizations were lower as age increased. The regression analysis showed that service utilizations of traditional Chinese medicine were influenced by gender, age, insurance premium, location, diagnosis and amount of medicine prescribed. Discussions and Conclusion: Service availabilities and medical resources from different regions in Taiwan significantly affected service utilizations in traditional Chinese medicine, as measured by both frequencies and costs. Traditional Chinese medicine was found to become the choice for treating general illnesses such as cold, cough and lower back pain, but not for critical illnesses. Therefore, how traditional Chinese medicine might best be used to care for the future aging population will be an important topic for health policy planning and health services research in Taiwan.

並列關鍵字

Elderly ； traditional Chinese medicine ； National Health Insurance ； utilization