病患自控式止痛與傳統定時注射式止痛對於大腸切除手術病患醫療耗用之比較

本研究旨在探討大腸切除手術個案術後止痛方式是否影響住院相關醫療費用，收集2007年至2018年於南部某區域教學醫院健保申報資料，研究對象共615人，以止痛方式分為病患自控式止痛(PCA)與傳統定時注射式止痛(CIIA)兩組。以PASW 18.0版作為資料工具，進行卡方檢定、獨立樣本t檢定及迴歸統計分析。結果發現止痛方式的不同對於個案ICU的停留天數(p<0.001)與請求止痛藥的次數(p<0.001)有顯著差異，在ICU的停留天數上使用PCA者比傳統定時注射式止痛者短0.623天，在請求止痛藥次數上使用PCA者比傳統定時注射式止痛者少5.855次；但對於住院天數及健保申報總點數則無顯著差異。希望本研究結果可以讓醫療團隊了解不同的止痛方式對住院醫療耗用的影響，提供一個參考依據。

關鍵字

病患自控式止痛；傳統定時注射式止痛；大腸切除；醫療耗用

並列摘要

The aim of this study was to investigate the analgesic factors that influence the medical care expenses in patients undergoing colon resections. We analyzed the database of NHI claims in a metropolitan hospital in south Taiwan from 2007 to 2018. There were 615 patients included. The methods of pain relief were divided into two groups: patient-controlled analgesia (PCA) and conventional intermittent injection alangesia (CIIA). Data was analyzed by PASW version 18.0 for chi-square test, independent sample t test and regression analysis. The results indicated that the days of ICU stay (p<0.001) and the times of request for painkillers (p<0.001) had statistical significance on the methods of pain relief. The PCA group was lower than CIIA group by 0.623 days in average days of ICU stay and by 5.855 times in average times of request for painkillers. However, the days of hospital stay and direct medical costs had no statistical significance on the methods of pain relief. We hope the results of this study can be used as a reference for option between medical expenses and methods of pain relief in hospitalization.