An Analysis of Low Back Pain Patients' Health Services Utilization－Using Panel Claims Data of National Health Insurance Beneficiaries, 1996-2001
|Keywords:||次級資料分析;全民健康保險;醫療利用;下背痛;National Health Insurance;Secondary data analysis;Health service utilization;Low back pain||Issue Date:||2004||Abstract:||
Low back pain is a common and important problem in terms of clinic and population health. Medical expenditures related to low back pain represent a certain proportion in the expenditures of National Health Insurance in Taiwan. The purposes of this research were to analyze health service utilization patterns and influential factors of single visit and acute low pack pain episodes for patients with low back pain. The source of the data came from claims data of the first and second set of sampled registry of beneficiaries of National Health Insurance from 1996 to 2001. ICD-9-CM with initial three codes as 720, 721, 722 or 724 were selected from the panel database. Cases with the illness located at cervix or thorax were excluded. A total of 69,242 person-times in ambulatory care and emergency, 692 person-times in hospitalization, and 23,764 episodes of acute low back pain (a treatment period that is equal or shorter than three months after an acute attack) were identified in the final analysis. The major results of this study were as follows:
For low back pain single visit from 1996 to 2001, the number of services for western medicine ambulatory care and emergency, Chinese medicine ambulatory care and inpatient were 85.0%, 14.1% and 1.0%, respectively. In terms of patient characteristics, those had ICD-9-CM as 724 (other and unspecified disorders of back), being female, 45-64 years old, received care from private hospitals, clinics, Taipei Branch and internal medicine system were in the majority. In terms of health service utilization patterns, the average medical expenses for western medicine ambulatory care and emergency, Chinese medicine ambulatory care and inpatient were NT $821.1, NT $603.4 and NT $37,380.5, respectively. In terms of acute low back pain episodes, those who were female, being 16-44 years old, beneficiary category as categoryⅠ, had enrollment payroll category at NT $16,500-22,800 were in the majority. In terms of health service utilization patterns for acute episodes, the average number of visit was 1.7 times, and the average medical expense per episode was NT $1,933.6.
In low back pain single visit, all kinds of ambulatory and emergency care expenses for western medicine were significantly related to the ICD-9-CM codes, age, whether or not having major illness, ownership of the provider, contracted category, visiting place and visiting department. All kinds of expenses for Chinese medicine ambulatory care were significantly related to age, contracted category and visiting place. All kinds of expenses of hospitalization were significantly related to ICD-9-CM codes, age, whether or not have to pay copayment and contracted category of the provider. In acute low back pain episodes, the number of visits per episode was significantly related to age, beneficiary category and whether or not having chronic diseases. The amount of medical expenses excluding ward fees was significantly related to age, beneficiary category, whether or not have to pay copayment and whether having chronic diseases.
This study found ICD-9-CM codes related to low back pain, gender, age and beneficiary category of predisposing characteristics, the level of enrollment payroll, whether being low income family and whether paying copayment of enabling resources, whether having major illness and whether having chronic diseases of need, and ownership, contracted category, visiting place and visiting department of visiting place characteristics were important factors influenced low back pain patients’ health service utilization, although the significance on different fees were slightly different.
|Appears in Collections:||健康政策與管理研究所|
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