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研究生:賴怡如
研究生(外文):Lai, Yiru
論文名稱:影響成人糖尿病患者住院及可避免住院因素之探討
論文名稱(外文):Factors Affecting Hospitalization and Avoidable Hospitalization among Diabetic Adults
指導教授:張明正張明正引用關係邱政元邱政元引用關係
指導教授(外文):Chang, MingchengChiou, Jengyuan
口試委員:張明正邱政元梁亞文
口試委員(外文):Chang, MingchengChiou, JengyuanLiang, Yiawun
口試日期:2013-01-19
學位類別:碩士
校院名稱:亞洲大學
系所名稱:健康產業管理學系長期照護組
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2013
畢業學年度:101
語文別:中文
論文頁數:112
中文關鍵詞:糖尿病住院可避免住院
外文關鍵詞:Diabetes MellitusHospitalizationAvoidable Hospitalization
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目的:
  探討成人糖尿病患者造成其住院及可避免住院之影響因素。

方法:
  本研究採橫斷式研究,利用2005年行政院衛生署國民健康局『國民健康訪問暨藥物濫用調查』資料檔 12-64 歲以下個人問卷資料進行分析並串聯2004年到2007年的全民健保資料庫,並以自述為糖尿病病患並願意串連健保資料庫年齡大於等於30歲者為研究對象共295人。以SPSS 12.0 版統計軟體進行卡方分析及羅吉斯複迴歸分析,影響糖尿病患者住院及可避免住院因素。

結果:
  以羅吉斯複迴歸分析結果發現,與糖尿病住院之相關因素為教育程度為高中、平均門診次數較多、自覺健康狀況之心理範疇分數較高及自覺健康狀況總分低者,較易發生住院;而已婚、籍貫為閩南人、家戶所得為三萬以下者、居住地為城鎮、察爾森合併症嚴重度指標2分以上者,較易發生糖尿病可避免住院。

結論:
  影響糖尿病住院的因素包含病患之教育程度、平均門診次數、自覺健康狀況之心理範疇及自覺健康狀況總分;影響糖尿病可避免住院的因素包括病患之婚姻狀態、籍貫、家戶所得、居住地都市化程度、察爾森合併症嚴重度指標。

Objective:
This study was to identify the factors associated with hospitalization and avoidable hospitalizations among diabetic adults

Methods:
The National Health Interview dataset was used to conduct the cross-sectional study; the dataset was provided by the Bureau of Health Promotion (BHP) “In 2005, the participants in the National Health Interview (NHI) survey showed the questionnaires of personal data files that were collected by the age groups from 12-64 years old. The potential participants provided their consent for data linkage with 2005 to 2007 National Health Insurance Research Database. The research objects in this study are greater than or equal to 30 years old, the total number is 295. SPSS 12.0 version for chi-square analysis and logistic multiple regression statistical analyses were performed to assess the difference between hospitalization and avoidable hospitalization among diabetic adults

Result:
The logistic regression analysis has found that the factors associated with diabetic hospitalizations consist of lower education, more outpatient visits, higher self-awareness of mental domain scores, and lower self-awareness of the overall total health score. Diabetic adults with lower incomes (less than $30,000) , married, the descent of the Fukien province, residing in the town, and Charlson Comorbidity Index (CCI) greater than 2 have the higher rates of admission for avoidable hospitalizations.

Conclusion:
Factors that affect diabetes hospitalization includes the patient’s level of education, average outpatient visits, self-awareness of health status, mental domain scores; Marriage status, the ancestry, family income, urbanization of residences and the Charlson Comorbidity Index (CCI) have great impact on the avoidable hospitalizations of diabetic adults.

中文摘要
英文摘要
目錄i
表目錄ii
圖目錄ii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 3
第二章 文獻探討 4
第一節 可避免住院 4
第二節 可避免住院之相關因素 13
第三節 糖尿病相關概念 17
第四節 糖尿病住院之相關實證研究 25
第五節 糖尿病可避免住院相關實證研究 30
第六節 台灣簡短 36 (SF-36)及察爾森合併症嚴重度指標簡介 34
第三章 研究方法 44
第一節 研究架構與假說 44
第二節 資料來源及研究樣本 47
第三節 資料處理流程 49
第四節 研究變項說明及操作型定義 51
第五節 統計分析方法 58
第四章 研究結果 59
第一節 糖尿病患者住院及可避免住院之卡方及描述性統計分析 59
第二節 糖尿病患者住院及可避免住院之多變項分析結果 90
第五章 討論與結論 101
第一節 研究結果討論 101
第二節 結論 104
第六章 建議與研究限制 106
第一節 建議 106
第二節 研究限制 107
參考文獻 108
中文文獻 108
英文文獻 109

表 目 錄
表 1 可避免住院之疾病及國際疾病分類碼 8
表 2 SF-36健康量表之構面資訊 36
表 3 SF-36需重新譯碼之題目分數轉換表 40
表 4 SF-36 構面分數轉換值對照表 42
表 5 CCI疾病診斷之ICD-9-CM對照表 54
表 6 研究變項一覽表 56
表 7 糖尿病患者是否住院與人口學變項之卡方分析 70
表 8 糖尿病患者是否住院與生活習慣之卡方分析 71
表 9 糖尿病患者是否住院與個人健康狀況之卡方分析 72
表 10 糖尿病患者可避免住院與人口學變項之卡方分析 86
表 11 糖尿病患者可避免住院與生活習慣之卡方分析 87
表 12 糖尿病患者可避免住院與個人健康狀況之卡方分析 88
表 13 糖尿病患者是否住院與否之羅吉斯迴歸分析 94
表 14 糖尿病患者可避免住院與否之羅吉斯迴歸分析 99

圖 目 錄
圖 1  SF-36計分流程圖 37
圖 2 研究架構 46
圖 3 研究對象選取流程圖 48
圖 4 資料處理流程圖 50


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