有無完治抗憂鬱症治療療程老年人之成本效益探討

隨著台灣社會越來越進入老人化時代，關於老人憂鬱的症狀和治療越來越受到重視，也已成為老人精神醫學及公共衛生領域重要的課題。然而，卻鮮少出現專注於老年人治療的抗憂鬱藥物治療的成本效益經濟研究。本研究對象於西元2000年與2001年期間，依「國家衛生研究院全民健保學術研究資料庫」之「門診處方及治療明細檔」與「門診處方醫令檔明細」進行串檔與統計分析。經國際疾病分類碼診斷碼前三碼為290、294、296、300被納入作研究對象，篩選出當年第一次為該診斷群之病患，並選取年齡滿65歲以上作為研究對象。研究結果顯示，在第二年用藥天數方面、用藥金額方面、診療金額以及藥事服務費完治組顯著高於未完治組，並且從成本效益分析結果中得知，相較沒有接受完整治療組別病人，完治組的病人治療老年憂鬱費用每多花1元抗憂鬱劑用藥成本，估計可獲得0.96元到1.29元的效益。

關鍵字

抗憂鬱劑；憂鬱症；老人醫療；成本效益分析

並列摘要

As Taiwan progress into an aged society, more attention has been directed to the clinical symptoms and treatments of depression for the elderly, which in turn has become an increasingly crucial issue in geriatric psychiatry and public health. However, there has been no cost-benefit study focusing on the effectiveness of antidepressant treatment for elderly patients. The major objective of this study is to analyze the impact of antidepressant drugs on elderly’s healthy care utilization under National Health Insurance (NHI) in Taiwan. A cross-sectional study was conducted, and the samples were selected based on related data obtained from the NHI database and the database developed by National Health Research Institutes. Patients who were over 65 years old and diagnosed for the first time as ICD_9_CM 290, 294, 296 or 300 during the period from 2000 to 2001 were identified as the treatment cases for analysis. Results shows that, among the studied variables, days of using drugs in the second year, total drug expenses, total treatment expenses, and service fee were significantly higher in the group of cases completing the treatment (＂complete cases＂) than those in the group of cases failing to complete the treatment (＂non-complete cases＂). Compared to their non-complete counterparts, complete patients were estimated to receive benefits in the amount from NT$0.96 to NT%1.29 when they spent a cost of one extra dollar on the antidepressant treatment for depression.

並列關鍵字

antidepressant drugs ； depression ； elderly ； cost-benefit analysis

國際替代計量

有無完治抗憂鬱症治療療程老年人之成本效益探討

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