新型血液透析聯機消毒及濾過乾粉筒裝置之改良

The Selection and Usage of Improved Dialysis Cartridge for On-line Hemodiafiltration and Endotoxin Disinfection

傅上峰(Shang-Feng Fu)

指導教授 ： 吳宗遠 ； 蔡祐輔

中原大學/理學院/化學研究所/博士(2022年)

https://doi.org/10.6840/cycu202200125

摘要

本研究是比較血液透析液配方組成成分比例、市場銷售需求之醫療利用性和治療費用的差異性，就未來血液透析濃縮液(粉)的研究發展進行探討。採用回溯性縱貫比對研究，依據2013年到2019年台灣腎病年報、台灣血液透析全民健保學術資料庫與透析市場銷售需求，擷取接受血液透析治療的相關資訊。進行統計比對患者人數、治療次數、醫療費用及血液透析濃縮液(粉)的使用量。本研究統計比對後，2019年以前濃縮比例36.83倍的血液透析液(粉)的使用比例為95.28%，2020年後隨著運輸成本高與醫護人員使用的方便性改使用濃縮比例35倍血液透析液(粉)的比率逐漸提高，更進一步推估未來的3年後，取得濃縮比例45倍血液透析液(粉)完整處方藥品許可證時，將取代濃縮比例36.83倍血液透析液(粉)的市場。經研究指出，血液透析患者的平均年門診次數156次，使用濃縮比例35倍、36.83倍和45倍血液透析液(粉)單次治療費用，濃縮比例45倍血液透析液(粉)單次治療所需的費用較低於，濃縮比例36.83倍血液透析液(粉)約35元，低於濃縮比例35倍血液透析液(粉)約40元。明顯影響血液透析中心的經營成本，另外，相關因素包含醫護人員可以直接使用(Ready to use)透析乾粉筒，無須提前30分鐘調配透析藥水，在配製藥水時，也可以避免透析藥水品質有受到污染的疑慮。評估三種濃縮比例透析液的單次治療費用、運輸成本、倉儲空間、使用的方便性和感控衛生因素後，其中濃縮比例45倍血液透析液(粉)將會是未來的主流。

關鍵字

血液透析、透析人數、血液透析濃縮液、醫療費用、透析乾粉筒

並列摘要

This study is to compare the composition ratio of dialysate, medical availability of market sales demand, the difference of treatment costs and the difference in treatment costs and the R D of hemodialysis concentrate (powder) is discussed in the future. Adopt retrospective longitudinal comparison research. Retrieve information about receiving hemodialysis treatment was based on the 2013-2019 Annual Report on Kidney Disease, Patients with Dialysis－Analysis of Health Insurance Database and dialysis market sales demand in Taiwan. Perform statistical comparisons on the number of patients, the number of treatments, medical expenses, and the amount of hemodialysis concentrate (powder). After statistical comparison in this study, the use ratio of 36.83 times hemodialysis concentrate (powder) was 95.28% by 2019. With the freight cost increase and use easy for medical staff, the ratio of using 35x hemodialysis concentrate (powder) will increase gradually in 2020 later. After further estimation for three years, received a complete prescription drug license for 45x hemodialysis concentrate (powder). It will probably replace the market of 36.83 times of hemodialysis concentrate (powder). According to the research literature, the average annual outpatient number of hemodialysis patients is 156. Use the single treatment cost of hemodialysis concentrate (powder) 35x, 36.83x, and 45x, the cost of hemodialysis concentrate (powder) for a single treatment is 45x lower than 36.83 x about 35 yuan, and lower than 35x about 40 yuan. Affect the business cost of hemodialysis center obviously, related factors include the dialysis dry powder cartridge that medical staff can directly use (Ready to use), no need to dispense dialysis syrup 30 minutes in advance, when mixing dialysate can also prevent quality pollution. After evaluating the single treatment cost, transportation cost, storage space, convenience of use, and hygiene factors of sensory control of the three concentrated dialysates, 45x hemodialysis concentrate (powder) will be the mainstream in the future.

並列關鍵字

hemodialysis, dialysis patients, hemodialysis concentrate, medical expenses, dialysis powder cartridge

參考文獻

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