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研究生:潘俊宏
研究生(外文):Chun-Hung Pan
論文名稱:以時間-事件發生法估計台北市之海洛因活躍使用者盛行率
論文名稱(外文):Time-to-Event Estimates of the Prevalence of Active Heroin Users in Taipei City
指導教授:陳為堅陳為堅引用關係
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:流行病學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:24
中文關鍵詞:海洛因時間-事件發生法盛行率流行病學
外文關鍵詞:herointime-to-event methodprevalenceepidemiology
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目的:以時間-事件發生法及海洛因戒癮個案治療病史,估計2001至2002年間台北地區海洛因使用人口盛行率。
方法:納入研究之個案,為至台北市立療養院海洛因解毒病房尋求住院戒毒之海洛因成癮者,該院亦為台北市南區的物質濫用治療核心醫院。藉用海洛因使用時間及過去住院戒毒次數等相關治療病史,估計海洛因使用者出現住院戒毒事件之年發生率,再由2001及2002年海洛因成癮者住院戒毒次數等資料,進一步估計出台北地區海洛因活躍使用人口總數及盛行率。
結果:在2001及2002年,分別有181及256次海洛因戒毒住院次數,估算所得之住院戒毒事件年發生率分別為0.086﹙95%信賴區間:0.068-0.104﹚及0.124﹙95%信賴區間:0.097-0.150﹚;責任區域內之海洛因使用人口數估計值分別為2103﹙95%信賴區間:1561-2645﹚及2071﹙95%信賴區間:1664-2478﹚人。台北地區年齡介於15到64歲的海洛因使用人口盛行率估計值分別為0.227%﹙95%信賴區間:0.168-0.285%﹚及0.223%﹙95%信賴區間:0.179-0.267%﹚。在敏感度分析中,顯示住院戒毒總次數之病史,會較海洛因使用時間及責任區域人口數,對於盛行率的估計產生更多影響。
結論:本研究顯示,若能獲得詳細的海洛因使用及相關治療病史,利用時間-事件發生法來估計海洛因活躍使用人口數及盛行率,是相當可行的方式。
Objective: This study employs the time-to-event method and the drug-using histories of heroin detoxification patients to estimate the prevalence of active heroin use in Taipei in year 2001 and 2002.
Method: Subjects were inpatients with heroin use from the detoxification units of the Taipei City Psychiatric Center, which was the core hospital responsible for the substance abuse treatment in the southern area of Taipei City. Treatment histories including the duration of heroin use and the total number of past admissions in public detoxification facilities were used to estimate the annual admission rate of heroin users. The size of the heroin-using population and the corresponding prevalence in year 2001and 2002 were then estimated.
Results: There were 181 and 256 admissions for heroin detoxification in year 2001 and 2002, respectively. The estimated annual admission rates of heroin detoxification were 0.086 (95% C.I. = 0.068-0.104) in 2001 and 0.124 (95% C.I. = 0.097-0.150) in 2002, while the estimated numbers of heroin users in the catchment area were 2103 (95% C.I. = 1561-2645) in 2001 and 2071 (95% C.I. = 1664-2478) in 2002. Hence the estimated prevalence of heroin use among residents aged 15-64 years in Taipei were 0.227% (95% C.I. = 0.168-0.285%) in 2001 and 0.223% (95% C.I. = 0.179-0.267%) in 2002. Sensitivity analyses further revealed that the history of total admission number might have more influence upon the prevalence estimate than the duration of heroin use or population size.
Conclusion: This study demonstrates that the time to event method is a feasible and practical one to estimate the size of active heroin-using population and the corresponding prevalence if the detailed information about heroin use and treatment can be obtained.
Abstract 3
Abstract (in Chinese) 5
Introduction 6
Method 7
Study sample 7
Data analysis 9
Results 11
Discussion 13
References 17
Table 1. Demographics and behavioral characteristics of heroin users admitted for heroin detoxification treatment. 21
Table 2. Estimates of the prevalence of active heroin users in northern Taiwan 2001-2002. 22
Table 3. Goodness-of-fit tests based on asymptotic likelihood inference for the index admission durations from heroin users. 23
Table 4. A comparison for the estimates of the prevalence of active heroin users using various assumptions. 24
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