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| Title: | 癌症病患急診醫療利用、原因、趨勢與相關因素探討-以1997-2008年為例 |
| Authors: | 龔佩珍 |
| Contributors: | 健康學院
健康產業管理學系 |
| Date: | 2009 |
| Issue Date: | 2010-05-07 03:06:35 (UTC+0) |
| Abstract: | 2005 年台灣平均每八分十五秒就有一人罹患癌症；2006 年每十三分鐘就有一人死
於癌症；2008 年則平均每四人當中即有一人罹癌。癌症已為高發生率、高死亡率且高醫
療花費之疾病，而在龐大的醫療支出中，急診醫療費用是為重大一環，根據中央健康保
險局的統計資料顯示，急診醫療申報費用從1999 年的82 億，提升至2006 年的127 億；
而急診的醫療利用次數亦從1999 年的每千人4,992 次，攀升到2006 年的每千人6,569
次。其中，癌症病患更為急診醫療資源的高利用族群之ㄧ，而影響急診病患利用急診醫
療的因素是否與癌症照護品質或是醫療機構特性有關，則有待進一步探討。因此，本研
究希望藉著瞭解影響癌症病患利用急診醫療的相關因素，藉以提供改善癌症醫療照護過
程品質之參考。
本計畫依研究目的分為三年期之計畫：第一年計畫擬利用國家衛生研究院之健保資
料庫，分析2006 年台灣新罹患癌症病患之人口學特性、共病等級、癌症治療方法等與
急診醫療利用之相關性，並以CCS（Clinical Classification Software）判定癌症病患利用
急診之病因。並利用羅吉斯迴歸分析探討影響新罹癌病患一年內是否利用急診醫療之相
關因素。
第二年則分析 1997-2008 年間，所有新罹癌患者一年內的存活情形與其主要照護機
構特性及其急診醫療利用之關係。利用t-test 及ANOVA 分析醫療照護機構特性及主治
醫師特性等因素，與患者急診醫療利用之差異。並利用存活分析探討影響新罹癌病患一
年內存活情形之相關因素。
第三年分析 1997-2009 年之癌症病患利用急診醫療次數之變化，及不同癌症病患急
診利用之差異性，並以趨勢分析（Trend Analysis）檢驗癌症病患多次使用急診醫療其趨
勢變化，最後利用羅吉斯迴歸分析探討影響癌症病患多次使用急診醫療之相關因素。
本研究藉由分析癌症病患使用急診醫療的因素與其存活時間，可提供癌症病患照護
品質改善之參考，以減少不必要之急診醫療利用。
On average, one person suffered from cancer per 8 minutes and 15 seconds in 2005, and
one died of cancer in 2006 as well as one of four persons suffered from cancer in 2008 in
Taiwan. Cancer was the disease with high incidence, high mortality, and high treatment cost.
Emergency care was one of medical care with huge amount of health care expenditures.
According to national health insurance (NHI) statistical data, the emergency care expenditure
increased from 8.2 billion in 1999 to 12.7 billion in 2006. The emergency care also increased
from 4,992 visits per thousand persons in 1999 to 6,569 visits in 2006. Cancer patients were
one of the high emergency care utilization groups. It needs to be investigated whether there is
an association between the emergency care utilization and health care quality for cancer
patients, as well as the characteristics of health care facilities. This research would like to
know the factors associated with cancer patients’ emergency care utilization and the results
would be the reference of improving health care quality for cancer care.
This study is a three-year research according to the study objectives. In the first year, this
research will apply 2006 NHI dataset to analyze the association between new cancer patients’
demographic characteristics, comorbidity level, treatment methods and their emergency care
utilizations. Clinical Classification Software (CCS) will be conducted to distinguish cancer
patients’ emergency care aetiology. Logistical regression will be used to investigate the
relative factors that influence emergency care utilization of new cancer patients within one
year.
The second-year research will analyze the association between the survival time of new
cancer patients within one year and the characteristics of health care facilities, as well as the
emergency care utilization from 1997 to 2008. Analysis of variance (ANOVA) and t-test will
be used to test the difference in the characteristics of the physicians and health care facilities
for cancer patients’ emergency care utilization.
Moreover, survival analysis will be applied to investigate the relative factors associated with
patients’ survival time within one year.
The third-year research will examine the variation of cancer patients’ emergency care
utilizations and distinguish the differences in different types of cancers from 1997 to 2009.
Trend analysis will be conducted to test the trend of cancer patients’ multiple emergency care
utilizations. Finally, logistic regression will be used to investigate the factors that influence
the multiple emergency care utilizations in cancer patients.
This research will analyze the relative factors that influence cancer patients’ survival |
| Appears in Collections: | [健康管理組] 國科會研究計畫
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