台灣「婦幼健康主題式資料庫」之建構與未來應用

Set-up and future applications of the Taiwan Maternal and Child Health Database (TMCHD)

目標：介紹「婦幼健康主題式資料庫」之建置過程與內容。方法：本研究利用我國出生登記、出生通報、死因統計（以上之資料年代為2004-2011）、與全民健康保險（簡稱健保）（1998-2011）等行政資料，完成親代與子代之健保資料連結；並將新生兒未投保前使用父親或母親身分證字號申報健保給付之紀錄補正回新生兒之就醫紀錄中。結果：本研究建置之「婦幼健康主題式資料庫」，由4種次檔案組成，包括（1）2004-2011年台灣所有活產新生兒之健保門診與住院紀錄及其出生登記的資料，如出生體重、妊娠周數、單/多胞胎等，且每一筆新生兒的健保就醫紀錄中新增該名新生兒父親與母親的身分證字號（加密）；（2）出生通報中每名母親吸菸、飲酒，及新生兒Apgar score；（3）所有新生兒父親與母親的健保門診與住院紀錄（含醫令資料）（1998-2011）；（4）新生兒與父母親之死因統計資料（2004-2011）。結論：「婦幼健康主題式資料庫」可以作為生命歷程研究之材料，也可提供較佳的訊息作為實證衛生政策的參考依據。

Objectives: To introduce the process of setting up the Taiwan Maternal and Child Health Database (TMCHD) and the content of the TMCHD. Methods: This project utilized the Taiwan Birth Registration Database (BRD), Birth Certificate Application (BCA), National Register of Death (NRD [2004-2011 for the BRD, BCA, and NRD]), and the National Health Insurance Research Database (NHIRD [1998-2011]) to inter-link the medical claims of offspring and their parents. An effort was also made to restore the medical claims of a parent to his/her newborn; medical claims are usually issued to one of the parent within 60 days after birth. Results: The TMCHD includes the information derived from inpatient/outpatient claims of all infants born between 2004 and 2011, in addition to a number of variables recorded in the BRD, including birthweight, gestational age, and single/multiple births. The variables in the BCA, such as maternal smoking, alcohol consumption, and newborn Apgar scores, were identified in a separate file. The medical claims of parents retrieved from the NHIRD, including medical orders (1998-2011) and the information pertaining to mortality retrieved from the NRD (2001-2011), were arranged in separate files. Conclusions: The TMCHD can be used as material for life course studies and may provide better information for evidence-based health policy.