台灣痔瘡患者看病特性的描述與分析

Characteristics of hemorrhoids patients in Taiwan- a descriptive analysis based on the national health insurance database

研究背景：痔瘡為一種常見的疾病，但是關於它的盛行數據，人口分布，以及就醫情況很少討論到。研究目的：了解台灣近十年來痔瘡的盛行率，就醫習慣以及接受手術治療比例，並分析影響手術治療的相關因子。研究方法：我們使用台灣健保資料庫，取自2000，2005，2010年百萬歸人檔，分析這三年就醫資料，選取ICD9的痔瘡診斷碼，以及相關檢查及治療碼，分析痔瘡在不同性別，年齡層的分布情形，以及各種痔瘡手術在不同性別，年齡層，各級醫院及不同共病指數的分布情形，影響手術治療的相關因子則以邏輯斯回歸分析。研究結果：根據我們的研究發現，台灣有症狀的痔瘡患者粗盛行從1.37%增為2.01%而校正盛行則是從0.58%增為1.01%，男女比例相近，好發年齡為61至80歲，接受手術治療的比例從39.6%降為27.4%。大多數患者在診所接受手術治療(37.23%)，至於接受痔瘡全切除手術患者則以區域醫院最高(9.59%)，查爾森共病指數越高者，接受手術比例越低。研究結論：台灣痔瘡的盛行逐年增加，接受手術治療比例則是逐年降低，以在診所接受手術治療的比例最高，共病指數較高患者接受手術比例較低。

 

Background and purpose: Hemorrhoids is a common disease, but its prevalence, patient population and health seeking behavior were not reported in Taiwan. The purpose of the study is to evaluate the prevalence of hemorrhoids and to explore the factors of undergoing surgical treatment such as gender, age, and Charlson comorbidity index. Methods: We used a nationally representative dataset (Taiwan’s National Health Insurance Research Database) containing 1,000,000patients, who were randomly sampled from the years 2000,2005, and 2010, respectively. Information of diagnosis, examination, and treatment were further retrieved. The factors in relation to undergoing surgery for hemorrhoids patients were analyzed by logistic regression model. Results: 1. From 2000 to 2010,the crude prevalence of patients with symptomatic hemorrhoids increased from 1.37 to 2.01%, and the adjusted prevalence increased from 0.58 to 1.01%. 2. From 2000 to 2010,the proportion of patients undergoing surgical treatment decreased from 39.6 to 27.4%.Among all types of medical facilities where the surgery was carried out, clinics had the highest proportion (37.23%,p<0.05).Patients without comorbidities also had higher proportion as compared with those with comorbidities. (29.57%, p < 0.05). 3. From 2000 to 2010, the proportion of patients undergoing total hemorrhoidectomy decreased from 13.06 to 7.75%. The propor-tion was highest in regional hospitals and in patients without comorbidities. Conclusions: From 2000 to 2010, the prevalence of hemorrhoids increased in Taiwan, whereas the pro-portion of patients undergoing surgical treatments decreased. Patients with a higher comor-bidity score had a lower surgical treatment rate. The highest proportion of medical facilities undergoing surgical treatment for hemorrhoids was clinics.