癌症住院病人精神醫療照護服務之醫療利用研究

The Utilization of Psychiatric Services in Cancer Inpatients

李宣緯(Hsuan-Wei Li) ； 葉玲玲(Ling-Ling Yeh) ； 王金龍(Ging-Long Wang) ； 徐聖輝(Sheng-Hue Hsu) ； 黃達夫(Andrew T. Huang)

《台灣公共衛生雜誌》 21卷4期 (2002/08) Pp. 278-288

https://doi.org/10.6288/TJPH2002-21-04-06

摘要

目標：檢視國內癌症病人於住院期間精神醫療利用情形及其影響因素。方法：分析國內某癌症專科醫院2001年癌症住院病人的精神醫療利用情形及影響其精神醫療利用的因素。並與1999年全國癌症住院病人的精神醫療利用比率進行比較。結果：根據某癌症專科醫院的資料分析結果發現，病人的年齡、住院日數和病人於該次住院合併精神疾病診斷碼的數目均會影響癌症住院病人是否接受精神醫療照護服務。且接受精神醫療照護服務癌症住院病人，其精神疾病診斷分布以適應障礙比率最高。在精神醫療用比率方面，國內癌症住院病人接受精神醫療照護服務的比普遍偏低，某癌症專科醫院癌症住院病人精神醫療利用比率4.1%，其他院則介於0％~2.2%之間。不同癌症類別病人接受精神醫療利用比率偏低，因此未來應積極探討腫瘤病人精神層面的需要。此外，未來健保支付制度調整時，亦需特別關注癌症病人精神醫療照護服務相關議題。

關鍵字

癌症病人 ； 醫療利用 ； 精神醫療服務 ； 精神科照會

並列摘要

Objectives: This study attempts to examine the utilization and factors affecting the utilization of psychiatric services of cancer inpatients in Taiwan. Methods: The study was conducted by analyzing the utilization and factors affecting the utilization of the cancer inpatients in a cancer center in Taiwan in 2001. Results were then compared with the utilization rate of the psychiatric care of all cancer inpatients throughout Taiwan in 1999. Results: Age, length of hospital stay and the number of psychiatric diagnosis were the factors that affect the utilization of psychiatric care. Of the psychiatric diagnosis of these patients, adjustment disorders were by far the most common. The utilization of psychiatric services for cancer inpatients was generally very low in Taiwan. It was 4.1 % in the cancer center and between 0% and 2.2% in general hospitals in Taiwan. Among cancer inpatients with different cancer sites, the utilization rate of the psychiatric care was higher in patients with central nervous system cancer. Conclusion: The low utilization rate of psychiatric services by cancer inpatients in Taiwan calls for an in-depth review of the necessity of psychiatric support in oncology patients. Furthermore, the appropriate utilization rate of psychiatric care for cancer patients should also be considered as an important issue in future restructuring of the reimbursement programs by the national health insurance.

並列關鍵字

cancer patients ； medical utilization ； psychiatric service ； psychiatric consultation-liaison service

參考文獻

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