淺談臺灣慢性腎臟病醫療照護現況與展望

Brief Overview of the Current Status and Prognosis for Chronic Kidney Disease in Taiwan

依據國家衛生研究院對於慢性腎臟病之研究顯示，我國20 歲以上民眾罹 志第3 至第5 期慢性腎臟病約佔全國人口6.9% '另依據美國腎臟資料登錄系統 2004 年報告顯示，連13 年以來，我國慢性腎衰竭發生率成長約3 倍、盛行率成 長約4 倍，成為世界發生率最高的國家，平均每人醫療費用耗用約50 萬點。為 加強防治、宣導國人正確的保健觀念，行政院衛生署暨各相關單位投入相當 的經費與心力，推動「慢性腎臟病整體照護計畫」，設置土限制門診透析總 額，每年給予一定比率的成長經費以執行醫療服務，透過健保局統計資料進 行總額執行成效之檢討，由醫療品質結構、過程及結果三大構面分析，經由 重大傷病卡統計發生率、盛行率與病床數，得知我國透析病床有供給過度及 醫療資源利用支出偏高的現象，確有改善的空間，而從醫療結果面觀察，因 病人數持續增加，照護品質仍屬停滯，再細步探究現況得知，防治照護的問 題在於健保給付、審查制度、醫療模式側重血液透析、防治體系疊床架屋等 方面，是建議政府可成立專責單位，整合各醫療資源，建構以病人為中心的 良好防治及照護體系。

According to the statistics from the Taiwanese Department of Health Research, approximately 6.9% (1.5million) of the Taiwan population over the ages of 20 are inflicted with Chronic Kidney Disease (stage 3 to 5). And of those with the disease, only 10% are aware of such condition and many times patients do not realize the damages incurred and delay seeking treatments. (,2006) Kidney disease has often been referred as one of the “silent killers” because the initial symptoms are not apparent and often overlooked; it is easy to miss the window of opportunity for adequate and proper therapy. Once a person has developed Chronic Kidney Disease (CKD), it is only a matter of time before it progresses into End Stage Renal Disease (ESRD). Currently the remaining viable treatment options are limited to kidney transplants and a lifetime of dialysis. Therefore, it is imperative that an early detection and prevention program should be developed in order to improve the health of the public.