異位性皮膚炎門診藥費支出分析

Drug Expense of Atopic Dermatitis in Taiwan

張偉斌(Wei-Pin Chang) ； 紀櫻珍(Ying-Chen Chi) ； 潘美連(May-Lien Pan) ； 宋晏仁(Yen-Jen Sun) ； 廖幼婕(Yu-Chien Liao) ； 楊建昌(Chien-Chang Yang) ； 劉德明(Der-Ming Liou)

《北市醫學雜誌》 10卷3期 (2013/09) Pp. 229-243

https://doi.org/10.6200/TCMJ.2013.10.3.06

摘要

目的：台灣地區異位性皮膚炎之盛行率2000至2004年異位性皮膚炎的盛行率為6％－14％，至今已擴增到約為13％－20％。全台目前約有300萬人罹患異位性皮膚炎。因此，對於健保整體門診藥費的支出也是相當可觀，故本研究利用全民健保資料庫來分析2008年台灣地區異位性皮膚炎門診病患藥品費用並與先前研究報告比較及討論之。方法：本研究選取2008年全民健康保險資料庫之一百萬人系統抽樣歸人檔資料為主體，為次級資料分析。研究對象為異位性皮膚炎門診病患，依照國際疾病診斷分類第九版臨床修正版為主，診斷碼為691.8和692.9之異位性皮膚炎患者門診次數與相關之變項採one-way ANOVA與Chi-square統計分析。結果：研究中共擷取939,412筆門診人次，女性門診比例約佔53.9％。門診處方開立用藥費用平均每人次藥費支出上為291.4元，門診給藥日數平均為7.01天，平均藥品筆數1.43筆。以性別來看，雖女性看診人次較多但平均男性病患的藥費、給藥日數與給藥藥品筆數皆高於女性病患，且年齡愈大者其藥費支出、給藥日數與藥品筆數愈多。以季節分析，看診季節以夏秋兩季看診人數約佔整體看診人數52％。結論：環境污染的增加、或氣侯的異常改變，均與異位性皮膚炎發生有相當程度的影響。本文藉由健保資料庫門診檔的分析可得以下之結論：（1）女性患者看診次數較男性多，但男性病患藥費普遍高於女性（2）秋夏兩季發病的人數佔了全年看診人數的一半以上，因此異位性皮膚炎患者需對氣候改變加以注意。（3）2008年門診病患平均每人次門診藥品藥費比起2004年約增加90元，門診藥費略微增加。（4）給藥天數與醫院層級有相當大的關係。（5）門診病患平均每張處方簽有1.4筆藥，比起2004年約下降了1.5筆數。本研究結果得知國內在異位性皮膚炎的用藥筆數上是遞減且藥費約微成長90元，應與健保局積極控制藥費成長有關，此研究建議未來可以長期延續研究追蹤，可作為健保藥物政策發展之研究參考。

關鍵字

異位性皮膚炎 ； 健保資料庫 ； 藥物費用支出

並列摘要

Objective: The prevalence of atopic dermatitis was 6%-14% in Taiwan in 2004. In 2008, the Department of Health, Executive Yuan, investigated the prevalence rate and found it to be 13%-20%. Thus approximately three millions people in Taiwan suffer from atopic dermatitis. This disease therefore has a huge impact on the finances of the National Health Insurance system in Taiwan, especially in terms of the cost of drugs. In this study, the aim was to explore the outpatient cost of drugs used to treat atopic dermatitis in Taiwan during 2008 and compare this with the findings for 2004. Methods: We used secondary data that had been extracted from the National Health Insurance Research Database of Taiwan. Outpatients diagnosed with atopic dermatitis and identified by the ICD-9-CM codes 691.8 and 692.9 were extracted for analysis using a databases program and SPSS. Statistical analysis was conducted using one-way ANOVA and the x^2-test. Result: A total of 939,412 records were identified as indicating a diagnosis of atopic dermatitis and these were extracted from the NHIRD database. Of these patients, 53.9% were female. The average expenditure on drugs was 291.4 NT$ per outpatient visit. The average time that each drug prescription covered was 7.01 days. While females outpatient visits were frequent than male outpatient visits, the average drug expenditure per visit was higher for female patients. Similarly, the average time covered by the drug prescriptions was longer for female patients. Conclusion: Furthermore, it was found that drug costs were higher and prescription times were longer for elderly patients. We also investigated the seasonal variations in the outpatient treatment of atopic dermatitis. Finally, the length of drug treatment and the average cost of drug prescriptions were the highest at medical centers.

並列關鍵字

atopic dermatitis ； drug cost ； outpatient

參考文獻

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