頁籤選單縮合
題名 | 泛自閉症兒童及青少年健保門診醫療利用與資源耗用初探=Ambulatory Healthcare Utilization and Medical Expenditure by the Child and Adolescents with Autism Spectrum Disorders |
---|---|
作者 | 管瓊瑛; 徐尚為; 林藍萍; 林金定; Kuan, Chiung-ying; Hsu, Shang-wei; Lin, Lan-ping; Lin, Jin-ding; |
期刊 | 身心障礙研究 |
出版日期 | 20130900 |
卷期 | 11:3 2013.09[民102.09] |
頁次 | 頁140-149 |
分類號 | 419.44 |
語文 | chi |
關鍵詞 | 泛自閉症; 青少年; 兒童; 資源耗用; 醫療利用; Adolescence; Ambulatory care; Autism Spectrum Disorder; Children; Healthcare utilization; Medical expenditure; |
中文摘要 | 泛自閉症發生率及盛行率在過去幾十年來有顯著上升的趨勢。根據我國內政部的統計資料中,自閉症人數自民國81年共計202名上升至2011年底,登記在案共有11,212名自閉症患者;而這些新增的自閉症孩童也伴隨著早期療育與醫療利用的需求增加。因此,本研究目的主要探討泛自閉症兒童及青少年的醫療利用趨勢與其醫療成本耗用的相關因素。資料來源主要使用2000年至2005年全民健保學術資料庫合併身心障礙檔的特殊需求檔之「門診醫療費用清單(CD)」,選取ICD-9-CM中N-code中任一是299.x之18歲以下泛自閉症個案,使用SPSS 20版進行統計分析。本研究採縱貫型研究,選取2000年至2005年的就診資料的人數從2,819人上升至5,273人。其中性別男性大於女性;年齡來說,以6-11歲者居多。泛自閉症兒童多數在法人醫院就診,另外公立醫院多於私立醫院。而就醫科別以復健科為最多、次之為精神科。總歸來說,2000年到2005年的泛自閉症兒童及青少年就醫人數與就診次數隨時間逐年增加,顯示每位孩童的醫療利用和資源耗用也隨之上升。以曲線估計初步分析2000年至2005年泛自閉症個案的醫療費用有逐年升高的趨勢(P<0.05,R^2=0.976)。而根據單變數卡方分析,影響泛自閉症孩童的醫療花費因素各年度皆不大相同,但是年齡層、重大傷病卡有無、有無低收入戶註記、醫療院所特性和就醫科別是每年都會影響醫療花費高低有差異。本研究建議,研究顯示泛自閉症兒童及青少年的門診就醫人數逐年增加,因泛自閉症是終身障礙,更需要政府提供醫療資源和衛生政策,而能減輕照顧者的負擔。 |
英文摘要 | The purpose of this research is to analyze the long term trend of medical utilization and medical cost in ambulatory care among child and adolescents with autism spectrum disorder. This study was a longitudinal study, and use 2001-2005 Taiwan National Health Insurance-persons with disabilities database, select the main diagnostic diagnosed with autism spectrum disorder (ICD-9-CM: 299.00-299.80), and those aged 18 and less included in the analysis. The patients with autism spectrum disorders increased from 2,819 in year of 2000 to 5,273 in 2005. With regard to the gender, male patients were four times more than female cases and aged 6-11 years used more ambulatory care than other age groups. The autistic patients were more likely to use private corporate hospitals than other kinds of hospitals in this study. The analyses also found that the autistic patients utilized more ambulatory care and medical cost gradually in the past years. We found the factors which affected ambulatory care visits were varied in each year. Since patients with autism spectrum disorders were lifetime disabilities, the governments should initiate appropriate healthcare policy to maintain good quality of medical care for this vulnerable population. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。