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  • 學位論文

高科技醫療之健康風險探討—以電腦斷層掃描為例

A Study on the Health Risks of High-Tech Medical-In case of Computed Tomography

指導教授 : 莊 謙 本
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摘要


鑑於電腦斷層掃描(CT)在我國全民健康保險檢(驗)查前10大申報點數統計經年排名居冠,且研究指出,民眾因醫學檢查接受的輻射曝露量恐增加罹癌的可能性。因此,本研究旨在藉由全民健康保險資料庫中重大傷病申請資料及CT申報資料探討癌症及CT利用的關係。以健保資料庫中2011年首度申請重大傷病之癌症及白血病患者為病例組,對照組則依據性別及年齡以1比4簡單隨機抽樣的方式進行配對抽樣。研究結果發現癌症之病例組與對照組在2000至2009年間,每人平均利用CT的次數具有顯著差異,病例組在CT利用的平均數及CT利用人數比例均較對照組略高;病例組中,關於性別、年齡及利用次數等變項在申請2011年度重大傷病癌症的勝算,經羅吉斯迴歸分析顯示,不同CT利用次數以利用1次至5次以上者達到統計上顯著差異,整體趨勢是利用次數較多,申報重大傷病癌症勝算較高,不同年齡及性別則未達統計的顯著水準。白血病部分,除利用次數2次者達到統計上顯著差異外,其他皆未有顯著差異。

並列摘要


In view of the computed tomography (CT) has long been ranked the crown of top 10 declaration points statistics in the National Health Insurance and research indicates that people expose to the radiation by taking the medical examination might increase the possibility of suffering from cancer. Therefore, this study aims to explore the relationship between cancer and CT by using the data of the National Health Insurance Database. Patients who first time applied for catastrophic illness of cancer and leukemia in 2011 as case group, the control group consisted of paired sample adopted a simple random sampling method based on gender and age. The study found that the case group and the control group in the per capita use of CT with significant differences between 2000 to 2009. The case groups were slightly higher than the control groups in the average number of times and patients of CT utilization. By logistic regression analysis, the odds among variables of gender, age and the number of CT utilization in applying for the catastrophic illness of cancer in 2011 showed that the number of CT utilization, the use of one to five times achieved statistically significant difference. The overall trend is the more the number of CT use; the higher the odds of declaration of catastrophic illness of cancer. Gender fell short of statistical significance level. The CT utilization of leukemia did not reach statistical significant difference except those who use two times.

參考文獻


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