疾病照護品質認證之醫療費用分析：以急性心肌梗塞為例

Analysis of Healthcare Costs Associated with Disease-Specific Care Certification Programs: A Case Study of Acute Myocardial Infarction

本研究旨在評估疾病照護品質認證對急性心肌梗塞（Acute Myocardial Infarction, AMI）病人接受經皮冠狀動脈血管成形術（Percutaneous Transluminal Coronary Angioplasty, PTCA）的醫療費用影響。研究採回溯性分析，以台灣某區域醫院的健保資料為基礎，比較認證前後AMI病人的醫療費用。研究對象依據ICD-10-CM（International Classification of Diseases, Tenth Revision, Clinical Modification）碼I21進行篩選，經排除特定條件後，分析其基本特徵及醫療費用差異。結果顯示，認證實施後，接受PTCA手術的AMI病人醫療費用明顯增加，尤其在復健治療、檢查費用、放射診斷等方面（P < 0.05）。此費用增加反映了醫院致力於提供更完善醫療照護的投入，包括提供復健處置等。本研究結果具參考價值，證實疾病照護品質認證對AMI病人醫療費用具顯著影響。建議未來研究應持續追蹤監測品質指標效果，以優化資源利用，並平衡照護品質和醫療成本。

This study evaluates the impact of disease-specific care certification on healthcare costs for patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction (AMI). A retrospective study was conducted using health insurance data from a regional hospital in Taiwan, comparing healthcare costs before and after certification for AMI patients. Patients with ICD-10-CM code I21 were included, excluding specific conditions, and differences in basic characteristics and healthcare costs were analyzed. The results showed a significant increase in healthcare costs for AMI patients undergoing PTCA after certification, particularly in rehabilitation therapy, examination fees, and radiographic diagnostics (P < 0.05). Despite the cost increase, this reflects the hospital’s efforts to provide more comprehensive medical care, including rehabilitation measures. This study provides valuable insights into the impact of disease-specific care certification on healthcare costs for AMI patients. Future research should further track and monitor the effects of quality indicators and optimize resource utilization to balance healthcare quality and medical costs.