碩士 / 國立台北護理學院 / 醫護管理研究所 / 98 / Purpose:The research is to probe into the medical utilization of Alzheimer’s disease in three consecutive years before diagnosis in Taiwan, and make a comparison with the control group.
Method: We selected the diagnosed patients who have been treated with Alzheimer’s disease medicines, and the non- Alzheimer’s disease (matched with age, sex, and Charlson index) as the control group, from the Database of the National Health Insurance, between 1996 and 2007. Then the medical utilization of Alzheimer’s disease patients in three consecutive years before diagnosis was explored and compared to the control group.
Result: The medical utilization of Alzheimer’s disease patients in the first year before diagnosis was obviously higher than the control group. The multivariate regression analysis of medical utilization shows that the number of average outpatient services in the first year before diagnosis increased 5.03, emergency treatment increased 0.24, inpatient admission increased 0.16, and average fees of outpatient services in the first year before diagnosis increased 13,928 dollars, emergency treatment increased 468 dollars, fees of inpatient admission increased 5,567 dollars, compared with the control group. When independent variables such as age, sex, Charlson-index were controlled, the differences between two groups all reached significant level. Further, we analyzed the medical department of outpatient services before diagnosis, we discovered that the neurology department and the psychiatric department increased 7.3 in the first year before diagnosis, but the internal medicine department and family medicine department decreased 0.9, this total difference (6.4) was close to the difference of whole outpatient services number (5.8). This research also finds that Charlson index is an important factor in predicting medical utilization. Besides, gender, age, medical treatment area and insurance category are related to medical utilization, and they are worthy of further research.
Conclusion: We collected a great deal of data about Alzheimer’s disease diagnosed patients and the control group for a long period of time (1996-2007) from the National Health Insurance Database, and we conclude that the medical utilization of Alzheimer’s disease patients is significantly higher than control group. It’s hard to know the reason because there are rare researches about this issue in our country before. We suggest more research attention should be directed to medical utilization in the future; through the medical payment reform, we can encourage the general and the first line medical practitioners, for example, those in family medicine departments, geriatrics departments…etc., to diagnose and cure the Alzheimer’s Disease aggressively.
| Identifer | oai:union.ndltd.org:TW/098NTCN0711001 |
| Date | January 2009 |
| Creators | Su-Chu,Hou, 侯素秋 |
| Contributors | Wei-Her,Tsai, 蔡維河 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 107 |
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