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頁籤選單縮合
題 名 | 臺灣核子醫學診療的長期趨勢=The Longitudinal Trend in the Utilization of Nuclear Medicine for Theranostics in Taiwan |
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作 者 | 洪茂欽; 黃正仲; 劉淑馨; 高志浩; | 書刊名 | Annals of Nuclear Medicine and Molecular Imaging |
卷 期 | 27:1 2014.03[民103.03] |
頁 次 | 頁12-22 |
分類號 | 414.93 |
關鍵詞 | 長期趨勢; 全民健康保險研究資料庫; 核醫使用率; Longitudinal trend; National Health Insurance Research Database; NHIRD; Utilization of nuclear medicine; |
語 文 | 中文(Chinese) |
中文摘要 | 背景:為了瞭解台灣核子醫學診療的使用率及長期趨勢,本研究利用全民健康保險研究資料庫1997年至2010年間的核醫就醫記錄進行分析。方法:利用描述性統計分析核醫診療使用率、醫療費用支出、醫院與地區分布情形,以線性迴歸分析使用率與醫療費用支出的長期趨勢,並採用Pearson相關分析法分析影響使用率的相關因子。結果:1997至2010年間平均每年核醫診療量為266,707次,約為每千人11.8次,總核醫使用量隨時間顯著增加,年增量為15,167次。全身骨骼掃描是最常進行的檢查項目,平均每年每千人3.8次;而壓力與重分布心肌灌注斷層掃描則增加最為快速,以每年每百萬人256次的頻率增加。至於醫療費用支出最高、成長也最快的核醫診療項目為全身正子造影,2004至2010年間平均每年支出為385,153,034元新台幣,並以每年94,230,576元的速度成長;其次為壓力與重分布心肌灌注斷層掃描,1997至2010年間平均每年支出為362,584,038元新台幣,並以每年38,221,848元的速度持續增加。此外,97%的核醫診療實施於醫學中心及區域醫院,區域醫院的分布比例有增加的趨勢;61%的核醫診療量集中於台北市、高雄市及台中市等三大都會區,然而此集中現象有減少的趨勢。結論:整體而言,台灣核醫診療的使用率及醫療費用支出在這14年間有明顯的變化,全身骨骼掃描、壓力與重分布心肌灌注斷層掃描、全身正子造影、全身炎症掃描、唾液腺閃爍攝影、三相骨骼掃描及淋巴閃爍攝影顯著增加,而鎝-99m甲狀腺掃描、碘-131甲狀腺掃描及24小時攝取量測定則明顯減少,此變化應與人口年齡老化有密切的關係。 |
英文摘要 | Background: This study investigated the long-term trend in the utilization of nuclear medicine for theranostics in Taiwan. All data of the nuclear medicine records were extracted from the National Health Insurance Research Database between 1997 and 2010.Methods: Descriptive statistical analyses were adopted to analyze the use rate and expenditure of nuclear medicine, hospital and region distribution of usage. Linear regression analysis was applied to assay the longitudinal trend in utilization, and Pearson correlation analysis was used to analyze the correlated factors.Results: The annual total number of nuclear medicine procedures was estimated to be 266,707 on average and 11.8 per 1,000 population with annual increment of 15,167 in 1997 ~ 2010. Whole-body bone scan was the most commonly performed examination with 3.8 per 1,000 people annually. The stress and redistribution myocardial perfusion scan was increased fastest with 256 increments per million people per year. In the aspect of medical expenditure, the whole-body positron emission tomography (PET) contributed the highest and was increased fastest with an annual increment of 94 million NTD, and average annual expenditure of 385 million New Taiwan Dollars (NTD) from 2004 to 2010. The stress and redistribution myocardial perfusion scan with an annual increment of 38 million NTD, and average annual expenditure of 363 million NTD from 1997 to 2010. In addition, 97% of the nuclear medicine procedures were performed in medical centers and regional hospitals, however, the latter tended to increase. Three major metropolitan areas, i.e., Taipei, Kaohsiung and Taichung, account for 61% of nuclear medicine clinics, yet, this phenomenon was decreased over time.Conclusion: The contents of nuclear medicine have significantly changed in the past 14 years in Taiwan. Whole-body bone scan, stress and redistribution myocardial perfusion scan, whole-body PET, inflammation scintigraphy, salivary gland scintigraphy, three-phase bone scan and lymphoid scintigraphy were all significantly increased, while Tc-99m thyroid scan, I-131 thyroid scans and I-131 uptake after 24 hours decreased distinctly. These changes may be correlated closely with the aging of Taiwan's population. |
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