應力性尿失禁婦女之首次就醫型態分析

應力性尿失禁是婦女下泌尿道疾病中最常見的問題之ㄧ，文獻顯示，應力性尿失禁發生率會隨年齡增加而增加，相關共病也會增加其風險，在與就醫選擇相關的文獻也指出，醫療院所類型及就醫地區的可近性，會影響到病人的就醫選擇，文獻顯示，僅有不到三成的婦女會主動尋求醫療協助，本研究藉由分析2004 年至2010 年健保資料庫就醫資料，探討應力性尿失禁婦女之首次就醫型態。結果顯示，越年輕的婦女選擇婦產科及女醫師的比率較高，有接受相關治療的比率也較高，而年長者則是選擇泌尿科比率較多；都市化程度越高的婦女，選擇醫學中心就醫的比率越高，而醫療費用也較高，都市化程度較低者無相關治療的比率較高；有共病者選擇區域醫院就醫的比率較無共病者高，而且有共病者選擇男醫師和混合治療的也高於無共病者。此研究結果可以提供不同的醫療院所，在推動應力性尿失禁防治工作時，設計不同的介入方式，使婦女更加瞭解尿失禁，能主動尋求醫療協助，以提升婦女的生活品質。

關鍵字

應力性尿失禁；首次就醫

並列摘要

Stress incontinence is one of the lower urinary tract disease in women, the literature shows that the incidence of stress urinary incontinence increases with age, associated comorbidity will increase their risks. It will affect the selection of patients for medical treatment. The literature shows that less than thirty percent of the women will take the medical advice. This study analyzing 2004-2010 National Health Insurance medical information database, to explore health services utilization of first visit for female stress incontinence. The results showed that the higher the young women choose obstetrics and gynecology and the ratio of female physicians have accepted the relevant treatment, the ratio is higher, while older people are more select urology, Women who choose the medical center for medical treatment, and health care costs are higher, the lower the degree of urbanization were no treatment-related; Patients who without comorbidity were choose the regional hospital. and who have comorbid and combination therapy were choose male physicians. The results of this study can provide different medical institutions, in promoting the prevention and treatment of stress urinary incontinence, different interventions designed to make women more aware of incontinence, can take the initiative to seek medical help to improve the quality of life of women.