台灣飲用酒精飲料盛行率與其相關疾病之醫療費用

Physical health, mental health, and social engagement in relation to awareness of and willingness to utilize Long-Term Care 2.0 Services among middle-aged and older adults in Taiwan: latent class analysis

目標：本研究旨在探討台灣民眾飲酒與其相關疾病所衍生之健保醫療花費。方法：利用2009與2013年國民健康訪問調查資料，依據民眾不同年齡別、性別之飲酒型態，建立酒飲研究世代。利用研究世代串聯健保資料，分別計算各種與飲酒相關疾病之相對風險與族群可歸因風險百分比，再根據2015-2017年全國性全民健保門診與住院酒飲相關疾病之就醫費用，估計可歸因於酒飲所造成之健保年平均就醫費用。結果：本研究發現約43%之民眾過去一年有飲酒。醫療費用部分，若僅以主診斷為主，年健保費用約為28億（95%信賴區間：5-63億元），若以主次診斷為主，年健保費用可達到56億（95%信賴區間：11-126億元）。結論：飲酒造成之醫療花費相當可觀，飲酒造成沈重之醫療經濟負擔應當可避免，倘若酒精所造成健康危害已確立，該如何減少飲酒以降低相關醫療成本支出是未來永續健保的課題之一。

Objectives: To estimate the medical expenditure associated with alcohol-related diseases in Taiwan. Methods: The age- and sex-specific study cohorts were based on data from the 2009 and 2013 National Health Interview Surveys. We then linked the study cohorts to National Health Insurance (NHI) claims data. This study estimated the relative risk and population attributable risk percent. Using nationwide inpatient and outpatient medical expenditure from 2015 to 2017, we estimated the annual medical expenditure attributable to alcohol consumption. Results: Approximately 43% of the enrollees had drunk alcohol in the preceding year. The estimated average annual medical expenditure attributable to alcohol consumption was NT$2.8 billion (95% confidence interval [CI]: NT$0.50–6.30 billion) when alcohol-related diseases were considered primary diagnoses. The corresponding figures were NT$5.6 billion (95% CI: NT$1.10–12.60) when alcohol-related diseases were considered primary or secondary diagnoses. Conclusions: The medical expenditure associated with alcohol-related diseases is substantial and should be prevented. Given that alcohol consumption is known to lead to adverse health outcomes, action should be taken to decrease alcohol consumption, which will in turn decrease the medical expenditure associated with alcohol-related diseases and reduce the burden on the NHI.