頁籤選單縮合
題名 | 高齡患者長期住院醫療利用影響因子之探討=Influential Factors of Medical Utilizations among Long-Stay Elderly Inpatients |
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作者 | 江昇達; 王勝廣; 高東煒; 方文輝; 張耀文; 高森永; 周稚傑; | 書刊名 | 臺灣老年醫學暨老年學雜誌 |
卷期 | 6:2 2011.05[民100.05] |
頁次 | 頁86-104 |
分類號 | 412.86 |
關鍵詞 | 長期住院; 高齡患者; 老人; 醫療利用; 影響因子; Elderly; Influential factor; Inpatient; Length of stay; Medical utilization; |
語文 | 中文(Chinese) |
中文摘要 | 背景及目的:健保局住院品質指標「30日以上超長住院率」自2004年監控以來,未能有效改善,而老人為住院醫療耗用與超長期住院中最大族群,所以研究高齡患者超長期住院醫療利用影響因子有其必要性。 方法:本研究自全民健康保險研究資料庫篩選出住院天數超過30天年紀 65 歲以上之高齡患者,用描述性統計各變項之分佈情形;並以推論性統計說明病人醫療利用之顯著差異 ( p < 0.05)。進一步以多元線性迴歸分析顯著變項與住院日數及醫療費用的相關情形。 結果:研究結果發現在長期住院的高齡患者中,含有女性、具重大傷病身分、住院期間有手術、私立醫院照護、呼吸系統疾病型態等因子者,其住院日數與住院醫療費較高,且達統計上的顯著差異。此族群在地區醫院有較高的住院日數及較低的醫療費用支出,並往北部及中部地區集中。 結論:此結果則可能與慢性照護需求增加、整體醫療分配不均與健保制度實施的方向有關。希望此研究結果可以提供健保未來在規劃老人照護需求上的參考。 |
英文摘要 | Background and purpose: Rate of Hospital stay more than 30 days, the Quality Indicator of BNHI (Bureau of National Health Insurance ), English revision is needed. The has the greatest consumption of inpatient care, also the largest group of long-term hospitalization inpatients. It is necessary to study the influential factors of medical utilizations among long-stay elderly inpatients. Method: The inclusion criteria are length of stay over 30 days and patient’s age over 65 years between 2001 and 2005. The data was analyzed by independent T test and one-way ANOVA test to look for the statistical significant differences between the variables. Multiple linear regression analysis was used to find the association of each of variables with the hospitalization cost and length of stay. Result: The results revealed that some factors were statistically significant correlation with higher hospitalization cost and longer length of stay, including female, identification of catastrophic illness, surgery, private hospital care and diseases involved respiratory tract. The data are statistically significant difference. Besides, the results reveal for the first time that this group reveal longer length of stay and lower hospitalization cost at district hospitals and concentrate to North and Central region of Taiwan. Conclusion: The results may be related to the increasing needs of long-term care system, uneven distribution of medical resources and the policy direction of health insurance. The government should establish the long-term care system, and strengthen for the long-term review appropriateness of hospitalized patients. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。