遠距健康照護介入措施對門診醫療利用之影響－以「銀髮族U-Care計畫」為例

The Effect of Tele-healthcare Intervention on Outpatient Care Utilization: A Case of Senior U-Care Program

林玉惠(Yu-Hui Lin) ； 陳文意(Wen-Yi Chen) ； 謝輝龍(Hui-Lung Hsieh) ； 蔡味娟(Wei-Chuan Tsai) ； 莊碧焜(Bi-Kun Chuang)

《長期照護雜誌》 17卷3期 (2013/12) Pp. 297-314

https://doi.org/10.6317/LTC.201312_17(3).0009

摘要

目標：本研究的主要目的在於評估遠距健康照護的介入措施對門診醫療利用的影響。方法：本研究的資料來源為竹山秀傳醫院與全民健保資料庫的門診醫療利用串檔資料。為了釐清遠距健康照護介入措施對門診醫療利用的影響，我們將樣本分為「高利用」與「低利用」兩個族群。我們使用差異中取差異法以及傾向分數配對等兩種計量模型，針對遠距健康照護介入措施實施前後的門診醫療利用差異進分析。結果：實證結果顯示，遠距健康照護介入措施將使得高利用族群的門診醫療利用明顯下降，但是對低利用族群的門診醫療利用之影響卻不降反升。整體而言，遠距健康照護介入措施將對每次門診醫療費用點數有明顯的抑制效果。結論：本研究的實證結果支持遠距健康照護介入措施，將有助於減緩臺灣全民健保財政負擔的政策意涵。

關鍵字

遠距健康照護 ； 傾向分數配對 ； 差異中取差異

並列摘要

Objectives: The purpose of this study is to evaluate the effect of the tele-healthcare intervention on outpatient care utilization. Methods: Data of outpatient care utilization were obtained from Chushang Show Chwan hospital and were verified from the National Health Insurance Research Database. In order to justify the impact of tele-healthcare intervention on healthcare utilization, the samples were separated into two groups, the high utilization group, and low utilization group. We used the difference-in-differences and propensity score matching methods to analyze the difference of outpatient care utilization before and after the implementation of the tele-healthcare intervention. Results: Our empirical results showed that the tele-healthcare intervention decreased outpatient care utilization in the high utilization group, but it impacted healthcare utilization positively in the low utilization group. In general, the tele-healthcare intervention could reduce outpatient care utilization on per visit basis. Conclusions: Empirical results from this study supported the policy implication of tele-healthcare intervention, which tele-healthcare intervention may mitigate the financial burden of national health insurance in Taiwan.

並列關鍵字

tele-healthcare ； difference-in-differences ； propensity score matching