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題名:台灣2006-2008年0-19歲兒童傷害住院特性及醫療費用     (30點)
Characteristics and Medical Expenditures of Children Aged 0-19 Hospitalized for Injuries in Taiwan, 2006-2008
著者:游斯雯(Si-Wen Yu) ;白璐(Lu Pai) ;林金定(Jin-Ding Lin) ;簡戊鑑(Wu-Chien Chien)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:傷害 ; 兒童 ; 全民健保資料庫 ; 醫療費用 ; Injury ; child ; National Health Insurance database ; medical expenditure
刊名:醫護科技期刊
頁碼:29-43
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

目的:瞭解台灣19歲以下兒童傷患住院特性並探討住院醫療費用之影響因子。方法:使用2006-2008年全民健保資料,串連「住院醫療費用清單明細檔(DD)」、「醫事機構基本資料檔(HOSB)」及「重大傷病證明明細檔(HV)」,選取N Code中主診斷或任一次診斷?800-999傷害個案,並以SPSS 18.0進行分析。結果:台灣2006-2008年計有142,287件19歲以下兒童傷害住院,3年總住院醫療費用?新台幣53.3億元。傷患年齡以15-19歲比例較高(40%),具有重大傷病的比例佔3%,就醫層級以區域醫院?主(45.8%),大多在中度都市化市?就醫(47.1%),傷害類型以骨折比例較高(34.3%),傷害原因多?交通事故(46.2%),而傷患只有1種傷害比例較高(64.7%),但有5.4%的傷患高達5種傷害。以多變項羅吉斯迴歸分析,兒童住院傷患醫療費用的影響因子有性別、年齡、重大傷病、就醫醫院層級、都市化程度、傷害類型、傷害原因及複合性傷害數。結論:骨折及交通事故?兒童最常見傷害類型及原因,溺水住院醫療費用最高,往後應預防兒童交通傷害所致骨折,並降低溺水醫療費用。
Purposes: This study examined the characteristics of injured children aged 0-19 in Taiwan and factors associated with hospitalization medical expenditures. Methods: This research used SPSS 18.0 software to study "inpatient expenditures by admissions (DD)", "registry for contracted medical facilities (HOSB)" and "catastrophic illness (HV)" data from the National Health Insurance Research Database between 2006 and 2008. We defined injury cases as patients identified by ICD-9-CM N Code "800-999". Results: A total of 142,287 injury cases among children aged 0-19 were registered during the 3-year 2006-2008 period. Medical expenditures associated with this group totaled NT5.33 billion. Those in the 15-19 age bracket accounted for the highest proportion of admissions (40.0%); A total of 3% of the group held a catastrophic illness card; Regional hospitals received the highest percentage of admissions (45.8%); Nearly half (47.1%) of patients were from urban areas; Fractures represented the largest (34.3%) injury category; Nearly half (46.2%) of injuries were associated with traffic accidents; and most patients (64.7%) were single injury cases. Factors associated with injury-related hospital medical expenditures included gender, age, catastrophic illness card, hospital type, urban demographic, injury type, injury cause and multiple injury status. Conclusions: The most common types and causes of injury included fractures and traffic accidents. Drowning was associated with the highest medical expenditure burden. To reduce overall expenditures, authorities should develop prevention strategies to reduce fractures caused by traffic injuries and strategies to reduce drowning-related medical expenditures.


    

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