DC 欄位 | 值 | 語言 |
dc.contributor | 楊銘欽 | zh-TW |
dc.contributor | Yang, Ming-Chin | en |
dc.contributor | 臺灣大學:醫療機構管理研究所 | zh-TW |
dc.contributor.author | 劉雅文 | zh-TW |
dc.contributor.author | Lao, Nga-Man | en |
dc.creator | 劉雅文 | zh-TW |
dc.creator | Lao, Nga-Man | en |
dc.date | 2008 | en |
dc.date.accessioned | 2010-05-05T10:58:11Z | - |
dc.date.accessioned | 2018-06-29T16:59:58Z | - |
dc.date.available | 2010-05-05T10:58:11Z | - |
dc.date.available | 2018-06-29T16:59:58Z | - |
dc.date.issued | 2008 | - |
dc.identifier.other | U0001-2501200810234000 | en |
dc.identifier.uri | http://ntur.lib.ntu.edu.tw//handle/246246/180706 | - |
dc.description.abstract | 本研究之目的為分析高血壓病人西醫門急診之重複醫療資源利用情形。研究資料以全民健保資料庫2005年承保抽樣歸人檔第一組至第四組共20萬人為基礎,定義國際疾病分類號第一、二、三欄中(主、次診斷碼)任一欄前三碼為401至405之高血壓病人(共20,209名)為研究對象,分析其重複醫療資源利用情形。 分析結果發現重複使用醫療資源者共8,050名,重複使用率為39.83%,重複用藥率為41.62%,用藥日數重複率為2.75%。重複使用醫療資源者中97.81%有重複用藥,重複用藥者平均每人累計重複用藥13.93天,平均每人累計重複藥費為508.46點。重複使用醫療資源者中19.65%有重複使用非藥品醫令,平均每人累計重複非藥品醫令費用為883.06點。有重複使用醫療資源之高血壓病人,平均每人重複的總醫令費用為670.89點,總醫療費用為3,331.19點。 性別方面,女性重複使用醫療資源之機率較男性高,但男性重複使用醫療資源之程度卻較女性高。年齡方面,年齡愈大者愈容易重複使用醫療資源,重複使用的程度也愈高。有重複使用醫療資源者中,免部分負擔者重複使用醫療資源的程度較需部分負擔者高。 病人之C.C.I.越高,會重複使用醫療資源的機率及程度越高,病人因高血壓而看診之醫師數、醫療機構數越多,重複使用醫療資源的機率及程度也越高。 病人的就醫選擇方面,無固定醫療機構權屬別及特約類別者重複使用醫療資源的機率較低,無固定醫療機構權屬別者重複使用醫療資源的程度也較低。論:絕大部分有重複使用醫療資源之高血壓病人有重複用藥。後續研究者可結合問卷,瞭解高血壓病人重複使用醫療資源之原因。 | zh-TW |
dc.description.abstract | The purpose of the study was to analyze hypertension patients’ overlapped medical utilization by using the 2005 National Health Insurance Registry for Beneficiaries Claims Data files, the medical service utilization data of 200,000 persons. This study identified 20,209 hypertension patients visited western outpatient and emergency department. The percentage of overlapped medical resources utilization, overlapped medication and overlapped days of prescriptions was 39.83%, 41.62% and 2.75%, respectively. Among hypertension patients who used overlapped medical resources, 97.81% also had overlapped medication. The average overlapped days of prescriptions and overlapped medication expenses were 13.93 days and 508.46 points. Nineteen point six percent hypertension patients who used overlapped medical resources also had overlapped non-drug orders. The average overlapped non-drug orders expenses were 883.06 points. The average overlapped total orders expenses of 8,050 hypertension patients who used overlapped medical resources were 670.89 points and the overlapped total medical expenses were 3,331.19 points. Females were more likely to use overlapped medical resources, but the degree was lower than males. Hypertension patients’ medical demand and overlapped medical resources utilization increased as age increased. Once the patients used overlapped medical resources, subjects who did not need to pay copayments had higher degree of overlapped medical resources utilization than their counterpart. The probability and the degree of overlapped medical resources utilization were higher when the Charlson comorbidity index was higher. The more the number of doctors and medical facilities patients visited because of hypertension, the higher the probability and the degree of overlapped medical resources utilization. Subjects who did not have a regular place of care were less likely to overlap medical resources utilization than their counterparts and the degree of overlapped medical resources utilization was lower. onclusions: The majority of the hypertension patients who had overlapped medical resources utilization also had overlapped medication. Future researchers can incorporate questionnaire to investigate the reasons of overlapped medical resources utilization. | en |
dc.description.tableofcontents | 致謝.............................................I文摘要.........................................IIbstract.........................................III一章 前言.....................................1一節 研究緣起................................1 第二節 研究目的...............................2 第三節 研究之重要性...........................2二章 文獻探討.................................3 第一節 高血壓之定義、分類及其臨床治療指引.....3 第二節 國內外高血壓病人之分佈及醫療資源使用情形.. 11 第三節 就醫行為之相關研究.................... 17 第四節 重複醫療資源利用之相關研究.............23 第五節 綜合討論...............................31三章 研究材料與方法...........................34 第一節 名詞定義...............................34 第二節 研究架構...............................38 第三節 研究假說...............................39 第四節 研究對象及材料.........................39 第五節 研究變項...............................39 第六節 資料處理與統計分析.....................43四章 研究結果.................................46 第一節 描述性統計之結果.......................46 第二節 推論性統計之結果.......................48五章 討論.....................................54 第一節 研究結果之討論.........................54 第二節 研究限制...............................61六章 結論與建議...............................62 第一節 結論...................................62 第二節 建議...................................64考文獻.........................................65 | en |
dc.format | application/pdf | en |
dc.format.extent | 1293362 bytes | - |
dc.format.mimetype | application/pdf | - |
dc.language | zh-TW | en |
dc.language.iso | en_US | - |
dc.subject | 高血壓 | zh-TW |
dc.subject | 逛醫師行為 | zh-TW |
dc.subject | 重複用藥 | zh-TW |
dc.subject | 重複使用醫療資源 | zh-TW |
dc.subject | doctor-shopping | en |
dc.subject | overlapped medical utilization | en |
dc.subject | overlapped medication | en |
dc.subject | hypertension | en |
dc.title | 以2005年承保抽樣歸人檔分析高血壓病人之重複醫療資源利用情形 | zh-TW |
dc.title | An Analysis of Hypertension Patients’ Overlapped Medical Utilization —Using National Health Insurance Registry for Beneficiaries Claims Data Files of 2005 | en |
dc.type | thesis | en |
dc.identifier.uri.fulltext | http://ntur.lib.ntu.edu.tw/bitstream/246246/180706/1/ntu-97-R95843001-1.pdf | - |
item.openairecristype | http://purl.org/coar/resource_type/c_46ec | - |
item.openairetype | thesis | - |
item.languageiso639-1 | en_US | - |
item.grantfulltext | open | - |
item.cerifentitytype | Publications | - |
item.fulltext | with fulltext | - |
顯示於: | 健康政策與管理研究所
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