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題名 | Mortality, Morbidity, Length and Cost of Hospitalization in Very-Low-Birth-Weight Infants in the Era of National Health Insurance in Taiwan: A Medical Center's Experience=健保實施後極低出生體重兒之預後及其醫療費用 |
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作者 | 張守治; 林其和; 林毓志; 葉純甫; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 41:6 民89.11-12 |
頁次 | 頁308-312+350 |
分類號 | 417.517 |
關鍵詞 | 極低出生體重; 死亡率; 罹病率; 費用; 住院日數; VLBW infant; Mortality; Morbidity; Cost; Length of hospitalization; |
語文 | 英文(English) |
中文摘要 | 全民健保開辦後對極低出生體重兒的預後,醫療費用,及住院日數的影響尚未知。但這些資料對當地醫療照顧計劃却是相當重要。這個研究的目的就是要去探討這些問題。因此我們收集民國84年3月到87年2月在本院出生而且住進新生兒加護病房體重小於1500公克的早産兒,分析其死亡率,罹病率,住院日數及醫療費用。總共有162個病人列入統計。結果發現死亡率依體重分別爲:72%(<750公克),31%(750-999公克),19%(1000-2149公克),3%(1250-1499公克)。罹病率整體而言分別爲:RDS74%;PDA,36%;NEC,9%;sepsis,42%;IVH,15%;ROP,31%;不正常腦幹聽力檢查,34%;CLD,17%。平均住院日數及醫療費用分別爲67.2天,62萬元。依體重分則爲108±38天,73±32萬元(<750公克);94±15天,99±35萬無(750-999公克);66±23天,64±36萬元(1000-1249公克);43±14天,39±37萬元(1250-1499公克)。整體而言,小於1500公克的早産兒其死亡率及罹病率仍高且住院日數較長併較高醫療費用。 |
英文摘要 | The impact of implementation of the National Health Insurance on the outcome, cost, and length of hospitalization of very-low-birth-weight (VLBW) infants is not clear in Taiwan. These data are important for the planning of medical care and regionalization in this area. This study was an attempt to examine these questions. We retrospectively collected mortality, morbidity, and length and cost of hospitalization data of VLBW (BW<1500g) infants between March 1995 and February 1998.There were totally 162 patients enrolled. The overall mortality rate was 21.6%; the birth weight (BW)-specific mortality rate was 72%, 31%, 19%, and 3% for infants with BWs of<750g, 750-999g, 1000-1249g, and 1250-1499g, respectively. The incidence of morbidities were: respiratory distress syndrome (74%), patent ductus arteriosus (36%), necrotizing enterocolitis (9%), sepsis (42%), intraventricular hemorrhage (15%), retinopathy of prematurity (31%), failure to pass auditory brainstem response (ABR) (34%), and chronic lung disease (17%). The average length of hospitalization was 67.2 days, and the cost per infant was 62×10^4 NT dollars; 108±38 days, 73±32×10^4 NT dollars if BW<750g; 94±15 days, 99±35×10^4 NT dollars if BW 750-999g; 66±23 days, 64±36×10^4 NT dollars if BW 1000-1249g; and 43±14 days, 39±37×10^4 NT dollars if BW 1250-1499g. In conclusion, VLBW infants are associated with high mortality and morbidity rates. They have long lengths and high costs of hospitalization, and therefore deserve attention in the implementation of the National Health Insurance and regionalization. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。