本研究之目的希望藉由健保資料庫之資料分析瞭解台灣地區40歲以上各年齡層10年間的醫療利用情形,長時間的觀察以瞭解進入65歲前醫療利用的情形,以提供未來保險政策擬定及推動中老年人預防保健政策之參考。 本研究以1996年全民健保資料抽樣歸人檔四組資料選取年齡大於等於40歲研究對象,共有研究對象49961人,使用1996~2005年之門診處方治療明細檔(CD)與住院醫療費用清單明細檔(DD),進行世代追蹤。 研究結果發現40-49,50-59,60-69歲門診的醫療費用逐年增加,十年成長率為69%、72%及41%。門診次數以70-79歲最高,1996年為26.4次,逐年增加至1998年28.6次後逐年減少,40-49歲、50-59歲及60-69歲逐年增加並且隨年齡增加而增加。80歲以上每年減少。 研究結果顯示各慢性疾病追蹤十年的結果,高血壓、糖尿病、惡性腫瘤、慢性腎衰竭、心臟病、呼吸疾病與肝硬化在40-49歲、50-59歲、60-69歲有比較高的比例;失智症、中風、巴金森氏症70-79歲及80歲以上的比例高。
The purpose of this study was to analyze the ten-year trend of health care services utilization among population aged over 40 in Taiwan area during 1996 to 2005 . The researcher of this study used the National Health Insurance Registry for 200,000 Beneficiaries Claims Data Files in 1996 and selected 49961 objects of study, and the data of this cohort study was analyzed from Ambulatory care expenditures by visits files and Inpatient expenditures by admissions files of National Health Insurance from 1996 to 2005. It was found that the medical outpatient cost at 40-49, 50-59, and 60-69 years old increased year by year with ten-year growing rates 69%, 72%, and 41% respectively. Besides, frequency of outpatient visits was the highest at 70-79 years old, upping from 26.4 in 1996 to 28.6 in 1998 and then declining year after year whilst that at 40-49, 50-59, and 60-69 years old rose every year as ages increased. As to that at over 80 years old, it descended annually. The study turned out to reveal that chronic diseases traced in ten years occupied higher proportions at 40-49, 50-59, and 60-69 years old, including hypertension, diabetes mellitus, chronic renal failure, heart disease, respiratory disease and liver cirrhosis. Meanwhile, dementia, CVA, and Parkinsen’s disease occupied higher proportions at 40-49 years old and at over 80 years old.