臺灣全身性紅斑狼瘡患者門、急診醫療費用分析

Analysis of Medical Expenses for Patients with Systemic Lupus Erythematosus in Taiwan

林佩珍(PEI-JAN LIN)

指導教授 ： 洪錦墩

中臺科技大學/管理學院/醫療暨健康產業管理系碩士班/碩士(2017年)

摘要

全身性紅斑狼瘡被臺灣全民健康保險列為重大傷病之一。其中以亞洲女性的發生率最高，據統計在亞洲每10萬人中有3至6人罹患此疾病。由於其屬於免疫性疾病，常併發其他疾病因而衍生健康問題及醫療費用而受到關注。本研究之目的在探討全身性紅斑狼瘡患者在門診、急診醫療利用與費用之現況及其影響因素。
本研究以國家衛生研究院2000年版全民健康保險學術研究資料庫提供的百萬抽樣歸人檔為資料來源，擷取2010年內初確診為全身性紅斑狼瘡患者為研究對象，並用傾向分數配對法對紅斑狼瘡患者之年齡與性別進行1：4之比率，擷取非全身性紅斑狼瘡患者為對照組確診全身性紅斑狼瘡患者有1,130人，其中男性為143人，女性為987人（約87.3%），另對照組為無全身性紅斑狼瘡者計有4,520人。
　　研究結果顯示全身性紅斑狼瘡患者於門、急診醫療利用與費用分別為15.92次、0.36次與34,954元、1,710.12元顯著高於無全身性紅斑狼瘡者的7.50次、0.13次與7,204.76元、343.35元。全身性紅斑狼瘡患者在門急診醫療利用次數於性別並無統計顯著差異，但於年齡小於17歲則門診次數及醫療費用有愈高之趨勢，急診則以年齡大於65歲的急診次數及費用有愈高之趨勢。以迴歸模型分析全身性紅斑狼瘡者若合併高血壓、糖尿病、腦中風、心衰竭四種疾病患者在門診次數、門診費用、急診次數、急診費用有愈高之趨勢。因此於全身性紅斑狼瘡患者若能控制其他共病症發生有助其減少醫療利用與醫療費用。

關鍵字

紅斑狼瘡 ； 醫療利用 ； 健保資料庫

並列摘要

Systemic lupus erythematosus is classified as one of the major injuries by Taiwan's universal health insurance. Women have the highest incidence in Asia. According to statistics in Asia, 3 to 6 out of every 100,000 people suffer from this disease. Since it is an autoimmune disease, often accompanied by other diseases and thus derived health problems and medical expenses. The purpose of this study is to investigate the current situation and influencing factors of outpatient and emergency medical use as well as expenditure by patients with systemic lupus erythematosus.
The research database is from the National Health Insurance academic research data and we capture the patients diagnosed as systemic lupus erythematosus in 2010 as the research object. In addition, we use propensity score matching method in the ratio of patients with lupus erythematosus and Non - systemic lupus erythematosus patients was 1: 4. There were 1,130 people diagnosed with systemic lupus erythematosus, including 143 males and 987 females (about 87.3%). The control group had 4,520 patients without systemic lupus erythematosus.
　　The results appears that systemic lupus erythematosus patients in the outpatient medical use, emergency medical use and both medical expenditure are 15.92 times, 0.36 times, NTD 34,954 and NTD 1,710.12, respectively. In addition, the patients without systemic lupus erythematosus are 7.50 times, 0.13 times, NTD 7,204.76 and NTD 343.35. It shows that the outpatient medical use, emergency medical use and both medical expenditure systemic lupus erythematosus patients are higher than those without systemic lupus erythematosus. There was no statistically significant difference in the gender of patients with systemic lupus erythematosus. However, at the age of less than 17 years old, the higher the number of outpatient and medical expenses, the higher the number of emergencies and costs of older than 65 years. Finally, the patients with systemic lupus erythematosus accompanied by hypertension, diabetes, stroke, heart failure whose outpatient visits, outpatient costs, emergency times and emergency costs are higher than those without four diseases. Thus patients with systemic lupus erythematosus should avoid comorbidity to reduce their medical use and medical expenses.

並列關鍵字

lupus erythematosus ； medical use ； health care database

參考文獻

中文文獻

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