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研究生:劉宛婷
研究生(外文):Liu,wanting
論文名稱:女性護理人員泌尿道感染之醫療利用與費用分析
論文名稱(外文):Expenditure of Healthcare Utilization of Urinary Tract Infection among Female Nurses
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:2012-07-30
學位類別:碩士
校院名稱:亞洲大學
系所名稱:健康產業管理學系健康管理組
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:62
中文關鍵詞:護理人員泌尿道感染醫療利用健保資料庫
外文關鍵詞:NurseUrinary Tract InfectionHealthcare UtilizationNational Health Insurance Research Database
相關次數:
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泌尿道感染常見於婦女,女性護理人員的罹病風險又高於一般女性。因此本論文以全民健保資料庫探討女性護理人員泌尿道感染的醫療利用情形。
由國家衛生研究院全民健保資料庫之「2005年承保抽樣歸人檔」100萬人,擷取2008年門診就醫申報資料,以罹患泌尿道感染的女性護理人員,去除資料缺失者後,取得樣本360名,探討女性護理人員泌尿道感染的醫療利用、醫療服務點數之差異。
本研究以SAS9.0版統計套裝軟體作為資料處理和統計工具,罹患泌尿道感染的護理人員多為21~30歲年輕女性,約佔50%,以求助於婦產科者為最多,次之為泌尿科、內科,就醫的醫療機構特約層級,以區域醫院最多、醫學中心者最少。就醫地點以台北分局最高。護理人員泌尿道感染醫療服務點數平均花費1303.75點,就醫科別及就醫醫療院所特約層級與醫療點數呈顯著相關。
在醫療服務利用次數方面,研究發現求診於腎臟科者、泌尿科醫療服務次數較多,醫療服務點數以就診地點以南區分局為最多,中區分局次之。

Urinary tract infections (UTIs) are a common disease in women; among them, female nurses have higher prevalence than the general population. This study used 2005 Longitudinal Health Insurance Database (LHID) from National Health Insurance Research Database (NHIRD) to explore the expenditure of healthcare utilization of urinary tract infection among female nurses in Taiwan. After deleting missing data, there are 360 female nurses who ever had urinary tract infection during 2008. Their utilizations of healthcare and expenditure are analyzed by secondary dataset, and by SAS 9.0.
The results of this study conclude that among those who ever had urinary tract infection, almost half of them are aged 21 to 30; most of them visited OB/GYN department, then the urology department, and then the internal medicine department. According to the level of hospitals they had visited, the highest visited level is the area-hospital; the lowest visited level is the medical center. Taking the region into account, the area in the Taipei branch has the highest visiting number. The mean of the point of expenditure is 1303.75. The visited department and hospital level are significantly associated with point of expenditure. The results of healthcare utilization have shown that nephrology department has the highest visiting number, with urology department the next; the results of expenditure points have shown that the highest visiting number is in the South branch, with the Central branch the next.
中 文 摘 要
Abstract
目 錄 i
表 目 錄 ii
圖 目 錄 iii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 2
第二章 文獻探討 3
第一節 泌尿道感染概述 3
第二節 泌尿道感染之診斷 7
第三節 泌尿道感染之藥物治療與預防 9
第四節 泌尿道感染好發因子的文獻回顧 17
第五節 醫療服務利用模式 20
第三章 研究方法 21
第一節 研究架構及研究假說 21
第二節 資料來源及研究樣本 23
第三節 研究變項名稱與操作型定義 27
第四節 研究對象 31
第五節 統計分析方法 32
第四章 統計分析 33
第一節 描述性統計分析 33
第二節 雙變項統計分析 44
第三節 多變項統計分析 48
第五章 討論與限制 54
第六章 結論與建議 55
第一節 結論 55
第二節 建議 55
參考文獻 56


表目錄
表3-1本研究資料來源和使用之欄位 25
表3-2上泌尿道感染─急性腎盂腎炎 26
表3-3下泌尿道感染─急性膀胱炎 26
表3-4自變項操作型定義 29
表3-5依變項操作型定義 30
表4-1前傾因素─護理人員罹患泌尿道感染年齡之分佈情形 33
表4-2使能因素─就醫地點與投保薪資之分佈情形 34
表4-3需要因素─是否有重大傷病及是否有慢性病之情形分佈 35
表4-4就醫場所特質─醫療機構特約層級與就醫科別之分佈 36
表4-5泌尿道感染就醫次數與年齡之分佈情形 38
表4-6泌尿道感染就醫次數與就醫科別之分佈情形 39
表4-7就醫次數與醫療機構特約層級之分佈情形 41
表4-8就醫次數與就醫地點之分佈情形 43
表4-9泌尿道感染醫療服務總點數之ANOVA分析─依年齡層分 44
表4-10泌尿道感染醫療就診總點數之ANOVA分析─依就醫科別分 45
表4-11泌尿道感染醫療就診總點數之ANOVA分析─依就醫地點分 46
表4-12泌尿道感染醫療就診總點數之ANOVA分析─依醫療院所特約層級分 47
表4-13與泌尿道感染有關的門急診醫療服務次數之線性迴歸分析 49
表4-13與泌尿道感染有關的醫療服務次數之線性迴歸分析(續) 50
表4-14與泌尿道感染有關的醫療服務點數之線性迴歸分析 52
表4-14與泌尿道感染有關的醫療服務點數之線性迴歸分析(續) 53


圖目錄
圖3 1 研究架構圖 21
圖3-2 研究對象篩選流程 31
圖4-1 泌尿道感染就醫次數與年齡之分佈情形 38
圖4-2 泌尿道感染就醫次數與就醫科別之分佈情形 40
圖4-3 泌尿道感染就醫次數與醫療機構特約層級之分佈情形 41
圖4-4 泌尿道感染就醫次數與就醫地點之分佈情形 43


中文文獻
台灣泌尿科學會(2012)。泌尿道感染保健手冊(第九版)。台北市:台灣泌尿科學會。
史明偉、回德仁(1993)。泌尿道感染之藥物治療。藥學雜誌,9(3),56-67。
行政院衛生署疾病管制局(2009)。侵入性醫療裝置相關感染監測定義。
余宏政(2002)。婦女泌尿道感染的認識與預防。台大醫網,13,31-32。
余泰慶(1995)。泌尿道感染及其治療。藥學雜誌,11(4),13-20。
周正修、張景勳、劉澤宗、羅慶輝(2006)。非複雜性泌尿道感染的診斷與治療。基層醫學,21(10),283-289。
陳宜君(2006)。院內感染控制介入評估研究整合型計畫。行政院衛生署疾病管制局96年度科技研究發展計畫。
賴敏裕(2003)。抗生素治療手冊。台北市:合記圖書出版社。
儲德馨、張淑貞、陳美琴、黃高彬(2007)。南部某醫學中心急診加護病房降低泌尿道感染改善方案。感染控制雜誌,17(1):p.1-10。
繆偉傑(2002)。復發性泌尿道感染的預防。台灣老年醫學會會刊,48,15-20。

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