碩士 / 臺灣大學 / 醫療機構管理研究所 / 95 / Recently the End-Stage renal disease (ESRD)patients who accept the Renal Replacement Therapy have increased quickly in advanced countries, and then such the countries have burdened the huge medical expenditure. There are many different topics intervene the ESRD researches in these countries. However, the high prevalence and incidence of ESRD and high dialysis expenditure of Taiwan, there are important implications to Taiwan and medical treatment, so if we analyze the global trend of the ESRD related research, maybe we could provide the result to the researchers in domestic, discussed the Taiwan’s experience which is meaningful to the international . We searched about the global ESRD related literatures by Bibliometrics method in the SCIE database, and found the cost-related researches by using abstract, topic and keayword, analyzed every layer, and then studied the major developing trend and sorted methods of these literatures about cost evaluation. There are 82 literatures during 1991-2006 which are conformed completely to our study’s purpose, and we sort out all kinds of intervention and quantities in every year in these literatures one by one. We find that 1.comparing in the renal replacement therapies, 2.comparing hemodialysis places, 3.EPO and 4.antihypertensive drugs are take turns the four dominant interventions, and these literatures quantity is approaching 60% of our ESRD economic evaluation database. And the interventions about organ transplantation are scatter, others such like reimbursement related, peritoneal dialysis related, nosocomial infection related, diabetic comorbided with ESRD related and other fragmentary topics intervening ESRD economic evaluations researches are infrequent and could not become the trend. The result of trend shows that we could analyze the cost-effectiveness in the different applicative dialysis ways in domestic about the ESRD cost-related domain in the future, and evaluate the total medical costs of these patients of different dialysis ways. And if the renal-transplantation is joined with to be compared, we could use the cost-utility analysis. The researches about how drugs-related impacting on the ESRD cost, the EPO-related research has been during the period of recession. And then we could think about the effect of other ESRD complication drugs on cost, such likes Vitamin D could prevent the ESRD) ,and analyze the cost effectiveness of antihypertensive-drugs be valued recently which could slow down the diabetes pre-ESRD patients into ESRD affect cost to provide for the policy.
In our study, we understand the limits of Bibliometrics method, and suggest that you have to be prudent when using such the method to evaluate a research performance, and find the meaningful direction by other ESRD clinical researches.
| Identifer | oai:union.ndltd.org:TW/095NTU05529022 |
| Date | January 2007 |
| Creators | Hsiang -Yun Liu, 劉湘雲 |
| Contributors | 張睿詒 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 103 |
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