末期腎病患者中醫利用影響因素之研究

Utilization and Associated Factors of Traditional Chinese Medicine among ESRD Patients

目的：西醫在某些方面仍無法滿足末期腎病患者所需，本研究探討台灣末期腎病患者在中醫門診醫療利用情形。方法：本研究藉由國家衛生研究院健康保險資料庫2009 年醫療利用資料，利用描述性統計、卡方檢定、邏輯斯迴歸、負二項迴歸及複迴歸等統計分析，探討末期腎病患者中醫利用與相關因素。結果：2,092 位末期腎病患者僅二成曾使用中醫，其中腹膜透析、固定於中區透析、罹患癌症與未罹患糖尿病的患者較可能使用中醫。固定於中區透析、罹患癌症之末期腎病患者中醫門診次數顯著較高；罹患癌症之末期腎病患者中醫門診費用顯著較高。結論：末期腎病患者仍以接受西醫服務為主，建議衛生主管機關針對患者選擇中西醫併用上，探討其治療有效性，以有效使用醫療資源。

Objectives: There are unmet needs in the Western medicine treatment of end-stage renal disease (ESRD). This study investigated the outpatient utilization of traditional Chinese medicine among ESRD patients in Taiwan. Methods: This cross-sectional study was extracted from the 2009 Health Insurance Coverage Database in the National Institutes of Health. Statistical analysis included descriptive statistics, chi-square tests, logistic regression, negative binomial regression, and multiple regression analysis. Results: Only 20% of 2,092 ESRD patients used TCM, including peritoneal dialysis, regular dialysis in a central Taiwan area, complicated with cancer, and without DM. Multiple regression analysis indicated that the regular dialysis area and patients with cancer were signifi cantly associated with Chinese medicine outpatient visits. Furthermore, patients with cancer were signifi cantly associated with TCM outpatient expenditures. Conclusions: ESRD patients are still dominated by Western medicine. Chinese medicine will only be used by a small number of patients to maintain or prolong existing renal function, rather than treatment of the underlying disease.