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研究生:林宣辰
研究生(外文):Hsuan-ChenLin
論文名稱:1997-2008年台灣地區因細菌性肺炎住院之流行病學特徵及其影響
論文名稱(外文):The epidemiology and impact of patient hospitalized due to bacterial pneumonia in Taiwan from 1997-2008
指導教授:陳國東陳國東引用關係
指導教授(外文):Kow-Ton Chen
學位類別:碩士
校院名稱:國立成功大學
系所名稱:公共衛生研究所
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:2011
畢業學年度:99
語文別:中文
論文頁數:82
中文關鍵詞:肺炎流行病學台灣地區
外文關鍵詞:PneumoniaEpidemiologyTaiwan
相關次數:
  • 被引用被引用:4
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  • 下載下載:57
  • 收藏至我的研究室書目清單書目收藏:0
目的:探討台灣地區肺炎流行病學以評估其造成的醫療花費,提供相關單位作為腦膜炎防治的參考。
方法:採用1997年至2008年,國家衛生研究院全民健康保險研究資料庫,利用資料庫內的住院醫療費用清單明細檔(DD 檔)、及醫事機構基本資料檔(HOSB 檔)合併進行分析,以國際疾病分類第九版挑選出主診斷代碼符合腦膜炎診斷的病患列入研究樣本。
結果:1997年至2008年共有212,177位病患因細菌性肺炎而住院,住院治療之住院平均天數約為11.76天,男性所有因細菌性肺炎住院之住院平均天數高於女性(12.74天vs.10.32天,P<0.0001)。在年齡層的比較上,0-1歲、2-4歲、5-17歲、18-39歲、40-64歲和65歲以上的所有因細菌性肺炎住院之住院平均天數分別為6.58天、5.17天、4.98天、7.91天、12.76天和17.30天,P<0.0001。在插管治療的比例上,男、女性和6個年齡層的結果皆達到統計上的顯著差異(P=0.0004;P<0.0001)。在醫療費用方面,所有因細菌性肺炎住院之平均住院一天健保支付的醫療費用約為台幣4,361元,每次住院健保需支付的總醫療費用約為台幣64,609元。
結論:細菌性肺炎及相關肺炎住院是台灣地區重要的公共衛生問題,未來應加強高危險族群施打流行性感冒疫苗之政策,以減少其感染肺炎及相關併發症後所造成的住院治療數、死亡數和經濟負擔。

Objectives:
The objective of this study is to examine the epidemiology profile of Bacterial pneumonia and disease burden in Taiwan.
Material and methods:
Adopt the National Health Insurance database from 1997-2008 of the National Health Research Institute, and merge the DD shelf and HOSB shelf to analyze data. From the nationwide inpatient database, creating a subsample that included hospitalizes with International Classification of Diseases, ninth revision, principal diagnosis code for pneumonia.
Results:
Between 1997 and 2007, there were 212,177 patients who hospitalized with bacterial pneumonia. The estimated length of day for bacterial pneumonia hospitalization in the male patients was higher than female patients((12.74day vs.10.32day,P<0.0001), and needed more further mechanical or artificial ventilation during hospitalization. Moreover, mean medical cost was NT 4,361/day, mean medical cost of each hospital stay was NT 64,609.
Conclusions:
Bacterial pneumonia is the main cause leading to death from pneumonia of children under 5 years in Taiwan. We should consider putting recommended vaccination for children in practice to reduce hospitalizations and deaths due to bacterial pneumonia.

緒論 4
研究背景 4
研究動機及目的 6
第二章 文獻探討 7
第一節 肺炎(pneumonia) 7
1.1 肺炎的定義與分類 7
第二節 肺炎的臨床表徵 9
第三節 合併症及其預後 10
第四節 肺炎之流行病學 11
4.1全球肺炎流行概況 11
4.2肺炎與小孩 12
4.3肺炎與成年人 13
4.4成人肺炎住院率 15
4.5孩童肺炎住院率 16
4.6細菌性肺炎病因之探討 17
4.7住院肺炎與危險因子 19
4.8住院肺炎與醫療花費 19
第三章 研究方法與材料 21
第一節 資料來源 21
第二節 研究對象 21
2.1全因性肺炎(all-cause pneumonia) 21
2.2個案排除條件 22
2.3肺炎致病因分類 23
2.4細菌性肺炎病原體 23
第三節 變項定義 24
第四節 統計分析 25
第四章 研究結果 26
第一節 基本人口學資料 26
第二節 細菌性肺炎致病原 27
第三節 因肺炎住院之住院發生率 28
第四節 因細菌性肺炎住院之住院天數、醫療費用與醫療資源耗用情形 33
4.1所有細菌性肺炎住院患者 33
4.3細菌性肺炎重症與非細菌性肺重症相關危險因子之探討 36
第五章 討論 38
第一節 國內外肺炎致病原之比較 38
1.1成人肺炎致病原 38
1.2孩童肺炎致病原 40
第二節 因細菌性肺炎住院之發生率 40
第三節 細菌性肺炎季節分布 42
第四節 因細菌性肺炎之住院平均天數 42
第五節 因細菌性肺炎住院之醫療花費 43
第六節 細菌性肺炎重症與非重症之相關危險因子探討 44
參考文獻 46
附錄一 全因性肺炎ICD code 對照表 78
附錄三 病毒性肺炎ICD code 對照表 79
附錄四 腦膜炎ICD code 對照表 80
附錄四 腦膜炎ICD code 對照表(續) 81
附錄五 敗血症ICD code 對照表 82

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