腸病毒疑似嚴重感染個案住院前之尋醫行為與醫療結果之關聯性探討

A Study of the Relationship between Suspected Enterovirus Contracted Patients’ Treatment Seeking Behavior and Treatment Outcome

游慧真(Huey-Jen You)

指導教授 ： 詹前隆

元智大學/資訊學院/資訊管理學系/碩士(2009年)

https://doi.org/10.6838/YZU.2009.00108

摘要

腸病毒難以預防且具高變異性，目前尚無疫苗及特效藥，是令人恐慌的原因。而幼童為高危險群，最易受到襲擊併發重症及死亡，其重症致死率約在10.0%至25.7%之間。過去對腸病毒大多是疾病發生機轉、致病因子、流行病學等研究，尚無針對個案尋醫行為過程予以探討，爰啟發本研究主題，期使大家對腸病毒有更多認識，俾便及時採取措施，阻斷相關重症的流行並減少重症死亡率及後遺症之發生率。
本研究旨在以健保資料庫，藉由Andersen健康服務利用模式，從傾向、使能、需求因素三個構面探討影響醫療利用影響因子，並探尋尋醫行為路徑，及不同尋醫行為路徑與醫療結果之關係。
研究結果發現，年齡越小(尤其三歲以下)罹患腸病毒，演變成極度嚴重情形越嚴重；流行區域在中南部，但由於積極治療度及警覺性高，演變成極度嚴重個案之比率越低，非流行區域如東部(東區分局)，一旦遭受感染，發生極度嚴重個案比率最高；手口足症及疱疹性咽峽炎是典型症狀，症狀明顯且不積極就醫治療者，其醫療結果最為嚴重，建議只要有症狀出現都應積極到中大醫院治療，不得稍有延遲，黃金治療時間是症狀發生兩天內。

關鍵字

腸病毒 ； 尋醫行為 ； 健康服務利用 ； 醫療結果

並列摘要

Enterovirus Epidermic related research is discussed in this report. The disease is difficult to be prevented because it’s highly mutative. Currently, there are neither vaccine nor effective medication can be implemented to treat this disease well .That’s why the disease causes people in panic. Infant belongs to the highly infected group because they are easily infected then dead. The transition rate from seriously ill to death due to this disease is approximately from 10.0% to 25.7%. In the past, most researches focused on infection mechanism and factors of Enterovirus Epidemic, as well as the epidemiology. But none of such studies which evaluated contracted patients’ behavioral correlation to seek medical treatment and the result of such treatment methodology. Hereby, the behavior of seeking medical treatment for Enterovirus Epidemic is discussed. By way of more familiar with Enterovirus Epidemic and correctively medical treatment to control the spread of serious cases and suppress the probability of mortality and side effect caused by Enterovirus Epidemic.
The purpose of this research is based on the information provided by the National Health Insurance Bureau. Through Andersen’s Health Services model to study the influence of health service utilization from the factors of predisposition, enabling and needs. Further more to study the behavior of seeking medical service and the relationship between seeking medical services and corresponding medical treatment results.
From the results we found that the younger the kids infected by Enterovirus Epidemic (especially younger than 3 years old), the easier the patients became the serious cases. Those who were infected in main infected area (Southern Central Taiwan) won’t become serious cases easily due to the active medical treatment and highly alert. On the contrary, patients will become serious cases easily once they are infected in the area where is not the main infected area (Eastern Taiwan). Rashes on finger-mouth-toe and angina with herpes are the typical symptom for the enterovirus patients. Those patients with obvious symptom but not being treated actively will become the most serious cases. We strongly suggest those who have symptom mentioned above should go to the hospital for treatment as soon as possible. The best time to heal the disease is within 2 days once the symptom happened.

並列關鍵字

Enterovirus Epidemic ； seeking medical treatment behavior ； health service utilization ； results of medical treatment

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