中西整合治療模式減少血液透析病患住院醫療費用

台灣慢性腎臟病及末期腎臟病的盛行率和發生率高居世界第一，而透析治療所花費的醫療費用也十分驚人，如何兼顧療效與降低醫療成本是很重要的議題。對於血液透析病人，過去的研究大多顯示中西整合治療的療效，缺少關於醫療費用支出的討論。因此本研究著重在分析中西整合治療後是否能減少醫療費用的支出。方法：本研究為回溯性研究，納入2014年1月至2018年6月臺南市立安南醫院接受中西整合治療的血液透析患者。比較中西整合治療病患在接受治療前三個月與接受治療後三個月的就醫次數與醫療費用的差異。結果：納入36位受試者。中西醫整合治療後與治療前相比，住院次數與住院醫療費用下降，不過急診次數與門急診醫療費用上升，而總醫療費用則是下降。住院醫療費用的降低有達到統計學上的意義（p=0.005）。結論：本研究是第一篇探討血液透析病患經中西整合治療後是否能減少醫療費用的支出，結果顯示中西整合治療後住院醫療費用降低有達到統計學意義，可惜的是總醫療費用雖然有下降，但無達到統計學差異，有可能是追蹤的時間太短導致效益無法顯現。從本研究可知，對於血液透析病患建議可採用中西整合治療模式以降低醫療成本的支出。

關鍵字

中西整合治療；血液透析；醫療費用

並列摘要

Background: The prevalence and incidence of chronic kidney disease and end-stage renal disease in Taiwan are the highest globally, so the medical costs of dialysis treatment are very staggering. It is a critical issue to reduce medical costs. Most of the past studies had shown the efficacy of integrated Chinese and Western treatment for hemodialysis patients, and there was a lack of discussion on medical expenses. Therefore, this study aims to analyze whether Chinese and Western medicine's integrated treatment can reduce medical costs. Method: A retrospective study was conducted at An-Nan hospital in Taiwan. Hemodialysis patients who received integrated Chinese and Western treatment were included from January 2014 to June 2018. We compared the differences in hospitalization, emergent unit visits, and patients' medical expenses with Chinese and Western integrated treatment three months before and after treatment. Result: 36 patients were included. After the integrated treatment of Chinese and Western medicine therapy, hospitalization costs reached a statistically significant reduction compared with before the treatment (p=0.005). Conclusion: This study is the first to explore whether integrated Chinese and Western treatment in hemodialysis patients were associated with reducingical expenses. After the statistical analyisis, the hospitalization medical expenses after treatment was signisignificantlyeased. However, the total expenses decreased no-significantly. It ma bmayrelated to shothe rt duration of this study. Therefore, it is recommended for hemodialysis patients to adopt an integrated Chinese and Western treatment model to reduce medical costs.

並列關鍵字

Integrated Chinese and Western medicine ； hemodialysis ； medical expenses

參考文獻

Lin MY, Cheng LJ, Chiu YW, Hsieh HM, Wu PH, Lin YT, Wang SL, Jian FX, Hsu CC, Yang SA, Lee HL, Hwang SJ. Effect of national pre-ESRD care program on expenditures and mortality in incident dialysis patients: A population-based study. PLoS ONE. 2018;13(6):e0198387.