頭頸部神經鞘瘤患者醫療使用情形之效益評估

陳柏秀

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頭頸部神經鞘瘤患者醫療使用情形之效益評估

Assessment on Medical Utilization of Head and Neck Schwannomas Patients

陳柏秀 , Masters　　Advisor：陳淑賢　　

繁體中文

頭頸部神經鞘瘤；效益評估；醫療使用；神經損傷； Nerve injury ； Head and neck schwannomas ； Assessment effectiveness ； Medical Utilization

Abstract │ Reference (116) │ Altmetrics

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Most schwannoma occurred in head and neck. Schwanmomas patients had nerve injury after operation. The aim of this study is to analyze the head and neck schwannomas patients that postoperative nerve injury and recurrence cost more medical fees. The medical costs for schwannomas care are growing to compare with the gradual of benign tumor. The study want to evaluate the medical expenses of the head and neck schwannomas patients that postoperative nerve injury, in order to facilitate the effectiveness assessment.
The resource of the data was collected from January 2003 to December 2010 in Taichung Veteran Hospital. The total sample size is 69 head and neck schwannoma patients. This study is a retrospective study. Statistical method contain contingency coefficient and chi-square test, one-way ANOVA and independent-sample t-test. 
The results indicate female are more easy to have head and neck schwannomas than male with the mean age of diagnosis at 47.84 years. Most of head and neck schwannomas has less than 2cm tumor. The most common observation was found along the facial nerve and auditory nerve. Tumor size and preoperative nerve symptoms would associate with tumor location. Tumor location, preoperative nerve symptoms and treatment would significantly affect postoperative nerve injury.
The findings of this study suggest to establish the standard operating procedures of caring the schwannomas patients, so that patients and his family become familiar with medical staff in the care knowledge and skills. The schwannomas patients can be treated effectively to reduce the physical and psychological harm and reduce the waste of medical resources.

Reference ( 116 ) 〈TOP〉

王文哲、蕭振仁、黃澤人、蔡森田(2000)。咽旁間隙之迷走神經鞘瘤—病例報告。中華民國耳鼻喉科醫學雜誌，35(6)，414-418。
連結：
吳仁佑、葉玲伶、閻愷正、黃達夫(2002)。甲狀腺切除論病例計酬之甲狀腺癌與良性甲狀腺疾患醫療資源耗用分析。臺灣公共衛生雜誌，21(6)，387-396。
連結：
呂宜興、張克昌、黃志銘(2003)。側咽腫瘤—57例的分析。臺灣耳鼻喉頭頸外科雜誌，38(2)，61-65。
連結：
宋霖霏、林昌誠、王泰隆(2005)。全民健保鼻中膈鼻道成形術論病例計酬制對醫療資源使用之影響。北市醫學雜誌，2(5)，465-474。
連結：
李彥德、劉博仁、陳禮平(2007)。喉部神經鞘瘤。澄清醫護管理雜誌，3(3)，15-18。
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