以2002~2011全民健保險資料庫分析 台灣地區神經性厭食症患者之住院醫療利用

Health Resource Utilization of Anorexia Nervosa Patients in Taiwan - An Analysis of National Health Insurance Research Database 2002-2011

黃韵捷(Yun-Chieh Huang)

指導教授 ： 周桂如

臺北醫學大學/護理學院/護理學研究所/碩士(2014年)

摘要

方法：使用健保資料庫2002-2007精神疾病住院病患歸人檔(PSY2)資料，串聯醫事機構資料檔(HOSB)及承保資料檔(ID)，取2002~2007年曾住院的神經性厭食患者，共171位為研究對象，得其2002~2011年資料，進行對台灣地區住院之神經性厭食症患者其醫療利用情形做資料分析。
結果：研究對象女性多於男性，平均年齡為26.33歲，年齡分層以15~24歲最多，高共伴疾病，多於醫學中心住院，皆為自願住院，平均住院天數為20.42天，每次住院平均醫療費用為54764.44元，平均住院次數為1.16次，住院科別以精神科最多，其次為內科及小兒科。影響2002~2007年住院醫療利用情形與年齡、共伴疾病數、低收入戶身分、重大傷病卡、投保金額及就醫特約類別有關。影響2008~2011年再住院患者其住院醫療利用情形與年齡、共伴疾病數、低收入戶身分、重大傷病卡有關。影響門診醫療利用的因素有性別、年齡、有共伴疾病、有重大傷病卡、低收入戶身分及就醫特約類別有關。2002~2007年間共伴疾病最多為精神疾患，其次為消化系統及血液系統，其中精神科共伴疾病以情感性精神病最多，其次為精神官能症、人格違常及物質濫用。2008~2011年間共伴疾病最多為感染，其次為精神疾患及損傷，其中精神科共伴疾病以情感性精神病最多，其次憂鬱疾患、人格違常及物質濫用。在比較台灣地區神經厭食症與非神經性厭食症患者在住院醫療利用差異之羅吉斯迴歸，分析顯示神經性厭食症患者較非神經性厭食症患者，於共伴疾病、低收入戶身份、重大傷病卡、投保金額及住院天數等有顯著差異。
結論：了解神經性厭食症其醫療利用情形後，對此疾病族群的疾病症狀，可以早期被辨識出及早期介入治療，可減緩其病程進入慢性化及增加治癒率。

關鍵字

健保資料庫 ； 神經性厭食症

並列摘要

Objective: the research on anorexia nervosa has a higher prevalence in Western countries and an increasing trend with the evolution of generations. Taiwan is still lacking in large-scale surveys.
Methods: using Psychiatric Inpatients Medical Claims Data (PSY2) of the 2002-2007 National Health Insurance database, together with Registry for contracted medical facilities (HOSB) and Registry for beneficiaries (ID), taking a total of 171 hospitalized patients with anorexia nervosa from 2002 to 2007 as the study subject and obtaining their data from 2002 to 2011 to carry out data analysis on the medical utilization of patients with anorexia nervosa hospitalized in Taiwan.
Results: Women were more than Men, with average ages 26.33; the ages from 15 to 24 are in the majority with a high rate of disease are mostly occurred in Medical Center, and are voluntary hospitalization, with the average hospitalization 20.42 days. Each medical expenses of hospitalization are 54,764.44 on average, and the average number of hospitalizations is 1.16 times; the hospitalization divisions are most psychiatric, followed by internal medicine and pediatrics. The impact on hospitalization utilization from 2002 to 2007 is related to age, the number of comorbidity, Low-income Family, Catastrophic Illness Card and the Contracted Category. The impact on hospitalization utilization for patients rehospitalized from 2008 to 2011 is related to age, the number of associated comorbidity, Low-income Family, and Catastrophic Illness Card. The impact on outpatient medical utilization is related to gender, age, the number of associated comorbidity, Catastrophic Illness Card, Low-income Family, and the Contracted Category. The associated disease from 2002 to 2007 was mainly mental illness, followed by the gastrointestinal system and blood system, among which associated disease of psychiatrics was mainly affective disorders, followed by neurosis, personality disorder and substance abuse. The associated disease between 2008 and 2011 was mainly infection, followed by mental disorders and injuries, among which associated disease of psychiatrics was mainly affective disorders, followed by neurosis, personality disorder and substance abuse. According to analysis of the differences in hospitalization utilization between patients with anorexia nervosa and patients with non-anorexia nervosa in Taiwan, analysis showed that patients with anorexia nervosa had significant differences in associated comorbidity, Low-income Family, Catastrophic Illness Card, insured amount and hospitalization days compared with patients with non-anorexia nervosa.
Conclusion: after the medical utilization of Anorexia Nervosa is understood, the disease symptoms of the disease population can be identified early and cured early so as to prevent the disease course from being chronic and increase cure rates.

並列關鍵字

Health Insurance database ； anorexia nervosa.

參考文獻

中文部分

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