跳到主要內容

臺灣博碩士論文加值系統

(18.97.9.172) 您好!臺灣時間:2025/02/12 02:54
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

我願授權國圖
: 
twitterline
研究生:李朝煌
研究生(外文):Chao-Huang Li
論文名稱:健保總額支付制度實施前後精神分裂症患者於精神專科醫院與綜合科醫院急性住院醫療利用比較之研究
論文名稱(外文):The Comparison of Medical Utilization of Acute Hospitalization of Schizophrenic Patients in Mental Hospitals and General Hospitals under the Effect of Global Budget
指導教授:張永源張永源引用關係
指導教授(外文):Yong-Yuan Chang
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:醫務管理暨醫療資訊學系碩士在職專班
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:2013
畢業學年度:101
語文別:中文
論文頁數:90
中文關鍵詞:醫療利用醫療資源精神分裂症精神專科醫院綜合科醫院總額支付制度
外文關鍵詞:medical utilizationhealth care resourcesschizophreniamental hospitalgeneral hospitalglobal budget payment system
相關次數:
  • 被引用被引用:1
  • 點閱點閱:205
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
研究目的
台灣自1995年實施全民健保制度以來,醫療費用逐年上升,為控制其成長幅度,健保總額預算制度於2002年7月全面實施。若以重大傷病住院醫療費用來分析,慢性精神病位居第三高,而其中精神分裂症則占據最主要的醫療資源利用。由於在台灣有兩種截然不同的醫療機構型態提供患者醫療照護,亦即精神專科醫院與綜合科醫院,所以本研究的目的為探討:(1) 精神分裂症患者人口學特質、疾病特質、精神醫療機構型態、總額支付制度之實施與急性住院醫療利用之相關性;(2)在精神專科醫院與綜合科醫院間,精神分裂症患者急性住院在醫療資源利用存在之比較;(3)了解健保總額制度實施前後,精神分裂症患者急性住院在精神專科醫院與綜合科醫院醫療利用之比較。
研究方法
本研究採用回溯性研究(Retrospective study)方式,並且採集全民健保資料庫之次級資料進行分析。研究時間為1996年1 月1日至2010年12月31日,共計15年間之住院病患資料,研究樣本選取的方式為選擇第一主要診斷代碼為295之精神分裂症病患共7,122人,由於健保總額支付制度於2002年7月全面實施,故研究將以此作為制度介入前後的時間點:1996年1月1日至2002年6月30日為制度實施前,而2002年7月1 日至2010年12月31日為制度實施後。醫療費用以醫院向健保局申報點數,使用1點=新台幣1元為表示,且依行政院主計處公布,2010年為基準年度之消費者物價指數(CPI),作為通貨膨脹率之調整。統計上以SPSS 18.0統計套裝軟體進行描述性統計,以及利用卡方檢定,複迴歸分析、獨立樣本t檢定,與重複量數變異數分析,進行研究假說之驗證。
研究結果
研究結果發現,總醫療費用方面,總住院日數、有其他合併症、精神專科醫院與年齡為預測之變項,而性別與重大傷病卡之有無則沒有顯著差異。總住院日數每多一天將增加總醫療費用1,244元,有其他合併症者比沒有其他合併症者則增加66,323元,精神專科醫院則比綜合科醫院增加66,536元,年齡每多一歲則減少559元。每人日費用方面,所有變項均呈現統計上顯著的差異:有重大傷病卡者每人日費用減少238元,男性比女性減少67元,精神專科醫院則增加94元,有其他合併症者比沒有其他合併症者增加57元,年齡則是每增加一歲,每人日費用就增加1.29元。綜合科醫院的總住院日數大於精神專科醫院;平均住院日數則是精神專科醫院的52.97天大於綜合科醫院的44.81天(P<0.0005);總醫療費用兩者沒有統計上顯著性的差異,但是平均每人日費用則是精神專科醫院高於綜合科醫院,分別為2,019元與1,958元。健保總額支付制度的實施、精神醫療機構型態與兩者之交互作用,均對精神分裂症患者急性住院之總醫療費用以及每人日醫療費用,有顯著性的差異;總醫療費用與每人日醫療費用,在總額支付制度實施後比較實施前有顯著的提升,而且在精神專科醫院也高於綜合科醫院。總額支付制度對於提升總醫療費用以及每人日醫療費用之影響,在精神專科醫院是顯著高於綜合科醫院。
結論與建議
如結果所述,精神專科醫院與綜合科醫院在精神分裂症患者急性住院之醫療利用有顯著差異,綜合科醫院的總住院日數與大於精神專科醫院,但是平均住院日數與平均每人日費用則是精神專科醫院大於綜合科醫院。總醫療費用與每人日醫療費用,在總額支付制度實施後比較實施前有顯著的提升,而且在精神專科醫院也高於綜合科醫院。總額支付制度對於提升總醫療費用以及每人日醫療費用之影響,在精神專科醫院是顯著高於綜合科醫院。本研究建議,精神醫療機構應依其不同治療模式發展合適的臨床治療準則與規範,善用醫療資源,並強化醫療品質之維護與進步,期使有限的醫療資源作最有效率的利用。


Objective:
Since 1995 we began to have the implementation of universal health insurance system, and medical expenses increased year by year; in order to control its growth rate, total health care global budget system was fully implemented in July 2002. In terms of catastrophic illness to analyze the cost of hospitalization, chronic mental illness ranked third highest, which will occupy most of schizophrenia medical resource utilization.
As in Taiwan, there are two distinct types of medical institutions to provide medical care of psychiatric patients, i.e. , integrated psychiatric hospitals and general hospitals, so the purpose of this study was to : (1) determine patients with schizophrenia demographics, disease characteristics, mental health institutions patterns, and acute inpatient care utilization correlation; (2) compare medical utilization of acute hospitalization of schizophrenia in mental hospitals and general ones; (3)compare medical utilization of acute hospitalization of schizophrenia in mental hospitals and general ones before and after the implementation of the global budget.

Methods:
This study is a retrospective study, and captures the NHI database. Duration of study time is 1 January 1996 to 31 December 2010, a total of 15 years of inpatient data, with research sample selection approach including the first principal diagnosis code of 295, i.e., patients with schizophrenia. There were 7,122 patients. Since the global budget payment system was nationally applied in July 2002, our research will serve as the point in time after the intervention system: January 1, 1996 to June 30, 2002 before the implementation of the system in 2002 July 1 date to December 31, 2010 as the system is implemented. Medical expenses to the hospital to BNHI points, 1 point = NT $ 1 is expressed and released by DGBAS, 2010 as the base year consumer price index (CPI), inflation adjustments .
SPSS 18.0 statistical software packages was used of descriptive statistics, chi-square test and multiple regression analysis, independent sample t test, and repeated measures ANOVA, to verify our research hypotheses.

Results:
The results showed that the total medical costs, the total number of hospital stay, other physical complications, psychiatric hospital and age to predict the variables, and gender and the presence or absence of catastrophic illness cards no significant difference. The total number of hospital stay per additional day will increase the total medical costs 1,244 NTD, those who had other physical complications increased by 66,323 NTD than those who have not , psychiatric hospitals increased 66,536 NTD than in general hospitals, more than a year old of age decreased 559 NTD. Cost per man-day, all variables showed a statistically significant difference: those who had catastrophic illness cards expenses less by 238 NTD per person per day, males more than females by 67 NTD, psychiatric hospitals increased by 94 NTD, those who had other physical complications increased more than 57 NTD, and one year old of age increased 1.29 NTD. General hospital had longer total number of inpatient stay; average length of stay is 52.97 and psychiatric hospitals is 44.81 days (P <0.0005); total medical expenses the two are not statistically significant differences , but the average cost per day is higher in psychiatric hospital with 2,019 NTD than 1,958 NTD in general ones . The implementation of the global budget payment system, different mental health institutions and patterns of interaction between the two were associated with significant different in total medical expenses and medical expenses per person per day; total medical expenses and per person day medical expenses were significantly high after the implementation of the system, and also higher in the psychiatric hospitals. The impact of global budget payment system for enhancing the total medical expenses and medical expenses per day on the psychiatric hospitals is significantly higher than the general ones.

Conclusion and Suggestion:
As the results described in our research, acute hospitalization of patients with schizophrenia in psychiatric hospitals and general hospitals had significantly different health care utilization; in the total number of inpatient days general hospitals is greater than psychiatric hospital, but the average length of stay and the average daily cost in the latter is greater than the former. Total medical expenses and medical expenses per day were growing after payment systemwas implemented, and also higher than in the psychiatric hospitas. The impact of global budget payment system for enhancing the total medical expenses and medical expenses per day on the psychiatric hospitals is significantly higher than the general ones.
This study suggests that mental health institutions should develop according to their different treatment modalities appropriate clinical treatment guidelines and specifications, use of health care resources, and to strengthen the quality of health care maintenance and advancement of the limited medical resources for the most efficient use.


目錄
致謝........................................................I
摘要.......................................................II
Abstract ...................................................V
目錄.....................................................VIII表目錄......................................................X
圖目錄....................................................XII
第一章 緒論.................................................1
第一節 研究背景與動機...................................1
第二節 研究目的.........................................6
第三節 研究重要性.......................................7
第二章 文獻探討.............................................9
第一節 精神分裂症疾病研究...............................9
第二節 精神醫療利用之相關研究..........................15
第三節 精神醫療機構之醫療利用與影響因子................22
第四節 總額支付制度與精神醫療利用相關研究..............26
第三章 材料與方法..........................................31
第一節 研究設計與研究架構..............................31
第二節 研究假說........................................34
第三節 資料來源與研究樣本..............................36
第四節 研究變項與定義 ................................39
第五節 統計分析........................................43
第四章 研究結果............................................45
第一節 研究樣本變項資料與醫療利用之描述性統計..........45
第二節 精神分裂症患者人口學特質、疾病特質、精神醫療機構
型態與急性住院醫療利用的影響因子分析.......................51
第三節 精神分裂症急性住院於精神專科醫院與綜合科醫院之醫療
利用差異比較....................................58
第四節 健保總額支付制度的實施對精神分裂症患者急性住院在精
神專科醫院與綜合科醫院醫療利用之差異比較........64
第五章 討論................................................74
第一節 精神分裂症急性住院醫療利用之影響因子探討........74
第二節 精神專科醫院與綜合科醫院醫療利用之差異比較......76
第三節 總額支付制度對精神專科醫院與綜合科醫院醫療利用差異
比較............................................77
第四節 研究限制與未來研究方向..........................78
第六章 結論與建議..........................................80
參考文獻...................................................83


中文部分
1.嚴玉華、許碩芬、方世杰、孫緒媛, 總額支付制度下個別醫院醫療費用預測模型建立-以某教學醫院為例. 澄清醫護管理雜誌, 2009. 5(2): p. 15-21.
2.譚家惠, 重大傷病住院病患醫療資源利用情形, 2004, 撰者.
3.羅紀琼、詹維玲, 醫院總額預算對費用單價與服務量的影響初探. 臺灣公共衛生雜誌, 2007: p. 261-269.
4.鄭靜明, 臺灣地區精神科憂鬱症醫療利用分析, 醫務管理研究所2006, 國立陽明大學: p. 103.
5.蔣語涵, 精神專科醫院與綜合科醫院精神科醫療資源利用與醫療品質之比較, 醫務管理學研究所碩士在職專班2011, 高雄醫學大學: p. 140.
6.鄒音美, 精神分裂症醫療給付改善方案之評估-以中部某精神醫院為例, in 健康產業管理學系健康管理組在職專班, 亞洲大學: p. 54.
7.葉玲玲、藍忠孚、鄭若瑟, 台灣精神分裂症患者精神醫療利用與費用之分析探討. 臺灣公共衛生雜誌, 2003. 22(3): p. 194-203.
8.葉玲玲, 台灣精神分裂症患者之健康照護需要與需求研究,公共衛生研究所2003, 國立陽明大學: p. 276.
9.葉玲玲, 嚴重精神病患罹病成本之研究,衛生福利研究所1995, 國立陽明大學: p. 98.
10.葉俊廷, 運用品質機能展開探討內部服務品質–以中部某精神專科醫院為例, in 工業工程與管理研究所碩士班2009, 雲林科技大學: p. 88.
11.黃國哲、陳怡樺、張蕙芝、張維容、溫信財、邱瓊萱, 總額支付制度實施後醫院的適應策略分析. 臺灣公共衛生雜誌, 2007. 26(4): p. 283-291.
12.黃品嘉, 全民健保支付制度演進與醫院生產效率. 2006.
13.陳素珊, 醫院總額支付制度實施前後對固定醫院就醫病患醫療利用比較之研究. 亞洲大學健康管理研究所學位論文, 2006.
14.陳素宜, 精神分裂症醫療給付改善方案實施成效評估-以全民健康保險資料庫為例,醫務管理學系碩士在職專班2012, 中國醫藥大學: p. 66.
15.陳明鐘, 私立精神專科醫院住院病患家屬滿意度之探討─以精神分裂症患者為例, 醫療機構管理研究所2006, 臺灣大學: p. 182.
16.陳大申, 臺灣地區精神疾病醫療利用分析, 醫務管理學研究所2003, 長庚大學: p. 118.
17.郭建成、崔秀倩、沈淑華、林麗娟、唐心北、張達人, 精神科醫院急性病房自動出院之預測因子. 臺灣精神醫學, 2005. 19(2): p. 128-136.
18.許碩芬, 楊雅玲,陳和全, 社會困境?-全民健保總額預算制下醫療提供者策略的均衡分析. 管理學報, 2007: p. 155-166.
19.莊念慈、黃國哲、許怡欣、郭乃文、魏中仁, 醫院因應總額支付制度之策略方案及其相關因素探討. 臺灣公共衛生雜誌, 2004: p. 150-158.
20.唐心北, 精神分裂症患者自動出院預測因子之探討-以一所公立精神專科教學醫院為例,公共衛生學研究所碩士在職專班2004, 高雄醫學大學: p. 101.
21.胡敦富, 精神專科醫療院所人力投入對服務績效影響之研究 -以台灣地區七家公立精神專科醫院為例- 高階公共政策碩士班2007, 國立中山大學: p. 106.
22.金家玉, 市場競爭對醫院產出表現的影響. 未出版碩士論文, 國立陽明大學, 2003.
23.邱献章, 全民健保個別醫院總額支付制度對精神科醫師處方行為影響之研究,高階公共管理組 2007, 臺灣大學: p. 52.
24.林慧修, 部分負擔對不同種類醫療服務之影響分析,醫務管理研究所2002, 國立陽明大學: p. 171.
25.林偕益, 精神分裂症患者醫療資源使用之影響因子探討,公共衛生學研究所碩士在職專班2004, 高雄醫學大學: p. 101.
26.沈詩佩, 醫院總額支付制度實施前後對精神分裂症患者醫療利用比較之研究,醫務管理研究所2011, 國立中山大學: p. 116.
27.李靜玟, 市場競爭及其他因素對精神醫療機構產出表現之影響, 醫務管理研究所2004, 國立陽明大學.
28.李名蟬, 精神專科教學醫院住院病人自傷趨勢及導致傷害與否之影響因素研究,健康產業管理學系健康管理組碩士在職專班2012, 亞洲大學: p. 48.
29.吳肖琪、吳義勇、朱慧凡、林嘉彥、李鐘祥、張錦文、藍忠孚, 我國醫院醫療品質指標使用之情形. 醫療品質, 2002. 2(2): p. 1-14.
30.余珮琦, 住院醫療服務市場之供給誘發需求現象探討, 2003, National Taiwan University.
31.江東亮, 臺灣醫療保健支出之趨勢分析. 2002.
32.朱菊新、李玉春、黃昱瞳、葉玲玲、黃光華, 醫院卓越計畫對精神分裂症門診病患換藥行爲之影響. 醫務管理期刊, 2007. 8(4): p. 301-316.
33. 行政院衛生署中央健康保險局: 全民健康保險簡介(2012-2013版). http://www.nhi.gov.tw/resource/Webdata/20782_1_2012-2013全民健康保險簡介.pdf
34. 行政院衛生署中央健康保險局:全民健康保險精神分裂症醫療給付改善方
案.
http://www.nhi.gov.tw/Resource/webdata/19255_2_公告-精神分裂症改
善方案.pdf
35. 行政院主計總處:國情統計通報(2012年10月引用) http://www.dgbas.gov.tw/lp.asp?CtNode=1481&CtUnit=690&BaseDSD=7&xq_xCat=09
36. 王俊凱、周元華, 精神分裂症, 2005, 臨床醫學.
37. 李明濱, 整合性精神醫療體系規劃研究第一年-病患分類、治療指引及品
質監控系統,行政院衛生署中央健保局八十八年下半年及八十九年上半年
度委託研究計劃 2000.
38. 劉蓉台, 精障個案社區整合照顧模式. 護理雜誌, 2007. 54(5): p.
11-17.
39. 宋鴻生, 精神醫療機構對不同支付制度之態度與醫療服務變化相關因素
探討, 2003, National Taiwan University Department of Health Care
Organization Administration.
40. 行政院衛生署:99年度醫療服務量
http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=
11924&class_no=440&level_no=3
41. 楊長興, 賴芳足,長庚醫學暨工程學院醫務管理學系, 全民健保實
施對於民眾醫療利用率影響之初期評估. 1996: 中央健康保險局.
42. 黃品嘉, 全民健保支付制度演進與醫院生產效率. 2006.
英文部分
1. Baca-garcia, E., Perez-rodriguez, M.M.,Basurte-villamor, I.,Quintero-gutierrez, F. J.,Sevilla-vicente, J.,Martinez-vigo, M.,Artes-rodriguez, .,Fernandez D.M.A.,Jimenez-arriero, M. A.,Gonzalez D. R.J., Patterns ofmental health service utilization in a general hospital and outpatient mental health facilities. European Archives of Psychiatry and Clinical Neuroscience, 2008. 258(2): p. 17-23.
2.Barro, J.R., Huckman, R.S. and Kessler, D.P. The effects of cardiac specialty hospitals on the cost and quality of medical care. Journal of Health Economics, 2006. 25(4): p. 702-721.
3.Bloom, J.R.,Wang, H.,Kang, S.H.,Wallace, N.T.,Hyun, J.K.,Hu, T., Capitation of Public Mental Health Services in Colorado: A Five-Year Follow-Up of System-Level Effects. Psychiatric Services, 2011. 62(2): p. 179-85.
4. Brown, S.,Barraclough, B.,Inskip, H., Causes of the excess mortality of schizophrenia. The British Journal of Psychiatry, 2000. 177(3): p. 212-217.
5. Cahoon, E.K., McGinty, E.E.,Ford, D.E.,Daumit, G.L., Schizophrenia and potentially preventable hospitalizations in the United States: a retrospective cross-sectional study. BMC Psychiatry, 2013. 13(1): p. 37.
6. Chien, I.C., Chou, Y.J.,Lin, C.H.,Bih, S.H.,Chou, P.,Chang,
H.J.,Prevalence and incidence of schizophrenia among national health
insurance enrollees in Taiwan, 1996–2001. Psychiatry and Clinical
Neurosciences, 2004. 58(6): p. 611-618.
7. Chien, I.C., Kuo, C.C.,, The Prevalence and Incidence of Treated Major Depressive Disorder Among National Health Insurance Enrollees in Taiwan, 1996 to 2003. Canadian Journal of Psychiatry, 2007. 52(1): p. 28-36.
8. Chisholm, D., Gureje, O.,Saldivia, S.,Calderón, M.V.,Wickremasinghe, R.,Mendis, N.,Ayuso-Mateos, J.L.,Saxena, S., Schizophrenia treatment in the developing world: an interregional and multinational cost-effectiveness analysis. World Health Organization. Bulletin of the World Health Organization, 2008. 86(7): p. 542-51.
9. Davies, L.M. and Drummond, M.F.,Economics and schizophrenia: The real cost. British Journal of Psychiatry, 1994.
10.De Hert,M.,Thys, E.,Boydens, J.,Gilis, P., Health care expenditure on schizophrenia patients in Belgium. Schizophrenia Bulletin, 1998. 24(4): p. 519-27.
11.Dickey, B., Assessing cost and utilization in managed mental health care in the United States. Health policy, 1997. 41: p. S163-S174.
12.Etter, J.-F. and Perneger, T.V., Health care expenditures after introduction of a gatekeeper and a global budget in a Swiss health insurance plan. Journal of epidemiology and community health, 1998. 52(6): p. 370-376.
13.Figueroa, R., Harman, J. and Engberg, J., Use of claims data to examine the impact of length of inpatient psychiatric stay on readmission rate. Psychiatric Services, 2004. 55(5): p. 560-565.
14.Fortney, J.C.P.,Xu, S. and Dong, F., Community-Level Correlates of Hospitalizations for Persons With Schizophrenia. Psychiatric Services, 2009. 60(6): p. 772-8.
15.Gilligan, J., The Last Mental Hospital. Psychiatric Quarterly, 2001. 72(1): p. 45-61.
16.Goldman, W.,McCulloch, J.and Sturm, R., Costs and use of mental health services before and after managed care. Health Affairs, 1998. 17(2): p. 40-52.
17.Goldner, E.M., Hsu, L.,Waraich, P.,Somers, J. M., Prevalence and incidence studies of schizophrenic disorders: a systematic review of the literature. Canadian Journal of Psychiatry, 2002. 47(9): p. 833-43.
18.Johnstone, P. and Zolese, G., Systematic review of the effectiveness of planned short hospital stays for mental health care. British Medical Journal, 1999. 318(7195): p. 1387-90.
19.Kirkbride, J.B.,Errazuriz, A.,Croudace, T.J.Morgan, C.,Jackson, D.,Boydell, J.,Murray, R.M.,Jones, P.B., Incidence of Schizophrenia and Other Psychoses in England, 1950-2009: A Systematic Review and Meta-Analyses. PLoS One, 2012. 7(3).
20.Kaplan H.I., Sadock B.J., Synopsis of Psychiatry, 9th edn. Williams
Wilkins, New York, 2003.
21.Kapur, K.,Young, A.S.,Murata, D.,Greer S.,Koegel, P., The economic impact of capitated care for high utilizers of public mental health services: the Los Angeles PARTNERS program experience. The journal of behavioral health services & research, 1999. 26(4): p. 416-429.
22.Kumar, K., Subramanian, R. and Yauger, C., Examining the market orientation-performance relationship: a context-specific study. Journal of management, 1998. 24(2): p. 201-233.
23.Leslie, D.L. and Rosenheck, R., Shifting to outpatient care? Mental health care use and cost under private insurance. The American Journal of Psychiatry, 1999. 156(8): p. 1250-7.
24.Mai, Q.,Holman, C. D.,Sanfilippo, F.,Emery, J., The impact of mental illness on potentially preventable hospitalisations: a population-based cohort study. BMC psychiatry, 2011. 11(1): p. 163.
25.Martin, B.C. and Miller, L.S., Expenditures for treating schizophrenia: A population-based study of Georgia Medicaid recipients. Schizophrenia Bulletin, 1998. 24(3): p. 479-88.
26.Mavranezouli, I., A Review and Critique of Studies Reporting Utility Values for Schizophrenia-Related Health States. PharmacoEconomics, 2010. 28(12): p. 1109-21.
27.McFarland, B.H. and Collins, J.C., Medicaid Cutbacks and State Psychiatric Hospitalization of Patients With Schizophrenia. Psychiatric Services, 2011. 62(8): p. 871-7.
28.McGrath, J., Saha, S.,Chant, D.,Welham, J., Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiologic Reviews, 2008. 30(1): p. 67-76.
29.Mojtabai, R., Fochtmann, L.,Chang S.W.,Kotov, R.,Craig, T.J., Bromet, E., Unmet Need for Mental Health Care in Schizophrenia: An Overview of Literature and New Data From a First-Admission Study. Schizophrenia Bulletin, 2009. 35(4): p. 679-95.
30.Moreno-Küstner, B.,Mayoral, F.,Rivas, F.,Angona, P.,Requena, J.,García-Herrera, J.M.,Navas, D.,Moreno, P.,Serrano-Blanco, A.,Bellón, J. A., Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis. BMC Health Services Research, 2011. 11(1): p. 257-257.
31.Mueser, K.T. and McGurk, S.R., Schizophrenia. The Lancet, 2004. 363(9426): p. 2063-72.
32.Nallamothu, B.K., Rogers, M.A.,Chernew, M.E.,Krumholz, H.M.,Eagle,
K.A.,Birkmeyer, J. D., Opening of specialty cardiac hospitals and use of coronary revascularization in Medicare beneficiaries. JAMA: the journal of the American Medical Association, 2007. 297(9): p. 962-968.
33.Palmer, B.A., Pankratz, V.S. and Bostwick, J.M., The Lifetime Risk of Suicide in Schizophrenia: A Reexamination. Archives of General Psychiatry, 2005. 62(3): p. 247-53.
34.Rice, D.P., The economic impact of schizophrenia. The Journal of Clinical Psychiatry, 1999. 60: p. 4-6; discussion 28-30.
35.Regier, D. A.,Narrow, W. E.,Rae, D. S.,Manderscheid, R. W.,Locke, B. Z.,Goodwin, F. K., The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry, 1993. 50(2): p. 85-94.
36.Rothbard, A.B.,Schinnar, A.P.,Hadley, T.P.,Foley, K.A.,Kuno, E., Cost comparison of state hospital and community-based care for seriously mentally ill adults. The American Journal of Psychiatry, 1998. 155(4): p. 523-9.
37.Rothbard, A.B., Kuno, E.,Schinnar, A.P.,Hadley, T.R.,Turk, R., Service utilization and cost of community care for discharged state hospital patients: A 3-year follow-up study. The American Journal of Psychiatry, 1999. 156(6): p. 920-7.
38.Rothbard, A.B., Kuno, E.,Hadley, T.R.,Dogin, J., Psychiatric Service Utilization and Cost for Persons With Schizophrenia in a Medicaid Managed Care Program. The Journal of Behavioral Health Services & Research, 2004. 31(1): p. 1-12.
39.Saha, S., Chant, D.,Welham, J.,McGrath, J., A Systematic Review of the Prevalence of Schizophrenia. PLoS Medicine, 2005. 2(5): p. e141.
40.Saha S, C.D.M.J., A systematic review of mortality in schizophrenia: Is the differential mortality gap worsening over time? Archives of General Psychiatry, 2007. 64(10): p. 1123-1131.
41.Salokangas, R.K.R. and Saarinen, S., Deinstitutionalization and schizophrenia in Finland: I. Discharged patients and their care. Schizophrenia Bulletin, 1998. 24(3): p. 457-67.
42.Sarlon, E., Heider, D.,Millier, A.,Azorin, J.M.,König, H.H.,Hansen, K.,Angermeyer, M.C.,Aballéa, S.,Toumi, M., A prospective study of health care resource utilisation and selected costs of schizophrenia in France. BMC Health Services Research, 2012. 12(1): p. 269-76.
43.Saxena, S., Sharan, P., Garrido, M.,Saraceno, B., World Health Organization''s mental health atlas 2005: implications for policy development. World Psychiatry, 2006. 5(3): p. 179.
44.Soumerai, S.B.,McLaughlin, T.J.,Ross-Degnan, D.,Casteris, C.S.,Bollini, P., Effects of limiting Medicaid drug-reimbursement benefits on the use of psychotropic agents and acute mental health services by patients with schizophrenia. The New England Journal of Medicine, 1994. 331(10): p. 650-655.
45. Sun, S.X., Liu, G.G.Christensen, D.B.,Fu, A.Z., Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States. Current Medical Research and Opinion, 2007. 23(10): p. 2305-12.
46.van Os, J. and Kapur, S., Schizophrenia. The Lancet, 2009. 374(9690): p. 635-45.
47.Wallace, C.,Mullen, P.E. and Burgess, P. , Criminal Offending in Schizophrenia Over a 25-Year Period Marked by Deinstitutionalization and Increasing Prevalence of Comorbid Substance Use Disorders. The American Journal of Psychiatry, 2004. 161(4): p. 716-27.
48.Wu, Eric Q,Shi, L.,Birnbaum, H.,Hudson, T.,Kessler, R.; Annual prevalence of diagnosed schizophrenia in the USA: a claims data analysis approach. Psychological Medicine, 2006. 36(11): p. 1535-1540.




QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top