運用關聯規則探討全身性紅斑狼瘡患者確診前之 門診醫療利用模式：使用全民健保資料庫

To Investigate the Use of Association Rules Before Outpatient Care Utilization Patterns of Patients Diagnosed With Systemic Lupus Erythematosus: Using the NHI Database

李佩諭(Pei-Yu Lee)

指導教授 ： 張怡秋 ； 胡雅涵

國立中正大學/管理學院/資訊管理學系/碩士(2014年)

摘要

全身性紅斑狼瘡(systemic lupus erythematosus; SLE) 是一種反覆、慢性、發炎性的自體免疫疾病，會侵犯全身各個器官，包括中樞神經系統，故已為全民健康保險認定之重大傷病之一。
根據中華民國思樂醫之友協會(2007)統計，全台約有一萬多人罹此疾病。調查發現，台灣全身性紅斑性狼瘡的盛行率與全球相似，約二千分之一，且好發族群多集中年齡介於15-44歲，且男女比例為1：9。目前的診斷是依一九九七年美國風濕病學會最新修訂的十一點全身性紅斑狼瘡分類標準，同時或連續出現四個以上的標準，即可歸類為全身性紅斑狼瘡。全身性紅斑狼瘡的症狀多元，患者可能會出現一個或多個症狀，只有極少數的人會出現所有症狀。由於症狀很廣泛，有時在早期很難診斷出來，且可能在初期時只出現單一症狀，而被誤診為其他疾病。
為探討準確診斷全身性紅斑狼瘡患者之特徵組合，呈現台灣全身性紅斑狼瘡患者確診前醫療利用情形，及與其他患者門診醫療利用的差異性，本研究以全民健康保險學術研究資料庫，擷取2002~2010年資料，應用Weka 3.6.6作為資料探勘工具，輔以關聯規則Apriori之探勘技術進行資料分析。
本研究樣本共有478人，確診為全身性紅斑狼瘡病患160人，依性別及年齡從「門診處方及治療明細檔」配對，做為每一確診個案的一群可能對照病例318人，研究結果為全身性紅斑狼瘡確診前1年有較高的門診醫療利用，全身性紅斑狼瘡確診前1年較高的門診醫療利用是風濕免疫科及復健科專科服務，準確診斷全身性紅斑狼瘡患者之特徵組合為女性、年齡15-24歲，常見之就醫科別為復健科、內科，常見之疾病為皮膚病及關節炎。

關鍵字

全身性紅斑狼瘡 ； 資料探勘

並列摘要

Systemic lupus erythematosus (SLE) is a repeated, chronic, inflammatory autoimmune disease, would violate various body organs, including the central nervous system, it has been recognized as the National Health Insurance, the one of catastrophic illness.
According to the SLE AID group of ROC (2007) statistics, Taiwan, about one million people suffer this disease. The survey found that Taiwan systemic lupus erythematosus and global prevalence is similar, about 1/2000, and the multi-ethnic predilection concentrated between the ages of 15-44 years old, and the male to female ratio is 1:9. The current diagnosis is 1997 according to the latest revision of the American College of Rheumatology SLE classification criteria eleven simultaneous or consecutive four or more criteria, can be classified as systemic lupus erythematosus. Symptoms of systemic lupus erythematosus diverse patient may appear one or more symptoms, and only a handful of people will be all the symptoms. Since the symptoms are very extensive, and sometimes difficult to diagnose at an early stage, and only a single symptom may occur in the early, and was misdiagnosed as other diseases.
To explore combinations of features accurate diagnosis of systemic lupus erythematosus patients, diagnosed before rendering medical utilization in patients with systemic lupus erythematosus in Taiwan, and other patients with outpatient care utilization differences, this study of the National Health Insurance Research Database, retrieved From 2002 to 2010 data, the application of data mining tool Weka 3.6.6 as supplemented by the Apriori association rules mining techniques for data analysis.
In this study, a total of 478 samples of people diagnosed with systemic lupus erythematosus patients with 160 people, according to sex and age from "Ambulatory care ezpenditures by visits" pairing, as each group of confirmed cases and 318 control cases may be, the results of systemic lupus erythematosus 1 year before diagnosis had higher outpatient medical use, systemic lupus erythematosus diagnosed before 1 year of outpatient medical utilization is higher Division of Rheumatology and immunology and rehabilitation specialist services, accurate diagnosis of patients with systemic lupus erythematosus features combination for women, ages 15-24, in respect of the common types of medical rehabilitation, internal medicine, the disease is a common dermatosis and arthritis.

並列關鍵字

Systemic lupus erythematosus ； Data mining

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