| 中文摘要 |
研究目的：由全民健保門診資料探討台灣上呼吸道感染個案之醫療資源利用特 性。 研究材料與方法：利用「全民健康保險研究資料庫」百萬人承保抽樣歸人檔，瞭 解台灣2007-2008年上呼吸道感染個案門診醫療資源利用分佈情形。 研究結果：研究期間上呼吸道感染個案共509,444人次。以不同領域執業醫師醫療 資源利用進行比較，有33.74%個案來自家庭醫學科，其次是中醫科 (33.71%)，再其次 是內科 (25.9%) (p<0.0001)；平均醫療費用由高至低分別是內科（462±1,745點）、中 醫科（441±85點）、家庭醫學科（348±172點）(p<0.0001)。利用複迴歸分析模式結 果顯示，性別、年齡、不同領域專科醫師、不同的中西醫案件、不同機構層級及疾病 嚴重程度為上呼吸道感染個案門診醫療費用之影響因子 (p≤0.05)。 研究結論：為避免病患就醫品質受到影響且符合臨床及醫療資源利用的一致性， 建議醫院經營管理者，在醫療資源分配決策時，除了校正疾病嚴重度外，應注意不同 領域執業醫師、不同機構層級、不同年齡分佈與性別都會對門診醫療費用產生影響， 此趨勢也將會影響全民健康保險資源配置。 |
| 英文摘要 |
Objective: The aim of this study was to explore the characteristic of medical resources utilization in the outpatients with upper respiratory tract infection (URI).Methods: This study used a nationwide-representative, sampled, longitudinal dataset of the National Health Research Institute (LHID2005). Multiple regression analysis was used to explore the distribution of medical resource utilization.Results: Total number of outpatient clinic visits during year 2007 to 2008 was 509,444. 33.74% of outpatient clinic visits came from family medicine, traditional Chinese medicine was 33.71% second high (33.71%) and internal medicine (25.9%) (p＜0.0001). The average fee of medical expense rank from high to low were internal medicine (462±1745 point), traditional chinese medicine (441±85 point), and family medicine (348±172 points) (p＜0.0001). Multiple regression model showed sex, ages, different specilist physicians, western and traditional Chinese medicine, different level hospitals and disease severity were the major risk factors. (p≤0.05)Conclusions: To avoid influencing the medical care quality and standardized clinical and medical resources utilization, we suggest hospital manager should understand that different specilist physicians, different level hospitals, ages and sex are the major predictors of outpatient medical source utility. This trend also will influence the distribution of national health insurance resources. |
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