分析全民健康保險研究資料2008年乾眼症於門診藥費支出之研究

An Analysis of Drug Expenses in the National Health Insurance Database for Dry Eye Syndrome Patients in 2008

目標：由於人口結構老化，各種疾病的罹患率亦隨之增加，眼睛疾病亦有同樣趨勢。其中乾眼症更是目前現代人眼疾主因之一。國內目前針對乾眼症的研究多在疾病的治療，鮮少對藥費支出等議題給予分析。故本研究利用全民健保資料庫來分析2008年台灣地區乾眼症門診病患藥品費用之支出情形。方法：以國家衛生研究院和中央健康保險局合作所建立之「全民健康保險研究資料庫」為基礎，本研究選取2008年資料庫中之一百萬人系統抽樣歸人檔資料為主體，為次級資料分析。研究對象為乾眼症門診病患，依照國際疾病診斷分類第九版臨床修正版為主，診斷碼為372.53之乾眼症患者門診次數與相關之變項（如性別、年齡層、醫院層級），採多變量分析與事後檢定分析。結果：研究中共擷取3,935筆門診人次，女性看診次數多於男性，但男性平均藥費（124.88元）大於女性平均藥費（97.62元）。門診處方開立用藥費用平均每人次藥費支出為111.2元，門診給藥日數平均為7.5天，平均藥品筆數1.9筆。以性別來看，雖女性看診人次較多但平均男性病患的藥費高於女性病患，且性別因素對藥費支出有顯著差異，對於年齡愈大者其藥費支出、給藥日數與藥品筆數愈多，亦有顯著差異於其他年齡層。研究中也發現醫院層級對於藥品筆數與給藥日數有顯著差異。以季節分析，季節因素與病患看診亦有顯著差異存在，民眾就醫多選擇以基層診所為主，科別則是眼科為主要就診科別。

Objectives: As the size of the elderly population increases, so does the incidence of eye illness. The dry eye syndrome is a major cause of discomfort; however, little research has investigated the expense of drugs used to treat it. Therefore, our purpose was to explore the cost of drugs for outpatients with dry eye syndrome in Taiwan in 2008. Methods: We extracted and analyzed secondary data from the National Health Insurance Research Databases. The visits of outpatients with dry eye syndrome (ICD-9-CM code 372.53) were subjected to multivariate analysis and post-hoc analysis. Results: We retrieved 3,935 outpatient visits from the NHIRD Databases. Females visited more frequently than did males, but the average drug cost was NT $124.88 higher for males. On average, it cost NT $111.2 for every outpatient visit, with an average of 7.5 drug delivery days per prescription. We also investigated the relative seasonal factors and found In general, drug delivery days and claimed cost of drugs for outpatients were highest in medical centers.