精神門診病患就醫特性研究－以某精神科醫院為例

Characteristics of Psychiatric Outpatients for Medical Treatment-An Example of a Psychiatric Hospital in TaichungCity

劉偉文 ； 林翠如

《寶建醫護與管理雜誌》 12卷2期 (2014/12) Pp. 60-70

https://doi.org/10.29681/PCJHM.201412_12(2).0005

摘要

近年來精神疾病的盛行引起世界性關注，WHO將精神疾病列為二十一世紀對人類有嚴重威脅的疾病之一，精神疾患的相關議題因而為研究重點。本研究針對臺中市某新設立精神專科醫院的人口特性、就醫特性（疾病主診斷）、醫療利用等資料進行回溯式探討，分析該醫院設立以來病患就醫相關之特性，作為未來個案醫院經營管理及其他精神科醫院設立的參考。本研究取個案醫院自2006年至2011年間門診38296筆，主診斷為295精神分裂症、296情感性精神疾病、300精神官能症之病患健保申報資料進行統計差異分析。結果發現，門診病患自2006年至2011年呈現逐年成長趨勢，其中以女性、19-64歲、情感性精神病居多，人口特性與就醫特性間達統計上顯著差異，醫療利用之給藥天數與年齡、診斷間達顯著差異，而年齡與醫療利用之就診次數間未達顯著差異。總結，個案醫院之統計資料顯示病患人口特性、醫療利用之差異分析與相關研究結果相似，就醫特性之主診斷統計結果與衛生福利部2011年衛生統計資料，精神疾患以精神官能症為最多，明顯不同；病患就醫特性應與醫療機構的設置區域及經營型態影響有關。建議未來在醫療政策上，正視精神疾病就醫特性的趨勢，以提供區域性適切的精神醫療計畫。

關鍵字

就醫特性 ； 精神科病患

並列摘要

In recent years, the prevalence of mental illness caused worldwide concern, and mental illness had been enrolled by WHO as one of seriously-threatening diseases to humankind in the twenty-first century and then followingly, psychiatry-related issues had become a study focus. This study performed a retrospective exploration of the data about opulation characteristics, characteristics of hospital visits (according to major diagnosis) and medical treatment utilization of a newly-established psychiatric hospital, to analyze the data associated with medical treatment since the launch of the psychiatric hospital, by the way, as the reference of its administration strategy and the establishment of the other psychiatric hospitals. This research take the sample cases of that hospital from 2006 to 2011, including 38296 OPD cases, with the major diagnosis of schizophrenia (ICD 295), affective psychotic disorders (ICD 296) and neurotic disorders (ICD 300) to obtain the patients National Health Insurance applying data for statistical variance analysis. As the study results, in the OPD cases, there's growth trend year by year in the number from 2006 to 2011, with female, 19-64 year-of-age and affective psychotic dominance, furthermore, there's significantstatistic difference between population characteristics and characteristics of hospital visits, between medication days and age, and between medication days and diagnosis, however, there's no significantstatistic difference, between age and the number of OPD visits. In conclusion, the statistic results of that hospital data demonstrate similarity with the results of relative studies in variance analysis between population characteristics and medical treatment utilization, in addition, it's obviously different about the statistic results of characteristics of hospital visits between the above-mentioned hospital data and the Ministry of Health and Welfare 2011 health statistics, which had the dominance of neurotic disorders; by the reasons, characteristics of hospital visits would be somewhat related with medical institution location and administrative pattern. It's highly recommended, in the future medical policy, that tendency of characteristics of psychiatric hospital visits should be emphasized, in order to provideregional appropriate mental health projects.

並列關鍵字

characteristics of hospital visits ； psychiatric patients