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研究生:簡伊伶
研究生(外文):Chien, Yi-Ling
論文名稱:資料探勘於醫療臨床路徑建立之應用
論文名稱(外文):The Application of Data Mining in Establishment of Medical Clinical Pathway
指導教授:黃怡詔黃怡詔引用關係
指導教授(外文):Huang, Yi-Chao
學位類別:碩士
校院名稱:國立屏東科技大學
系所名稱:工業管理系所
學門:商業及管理學門
學類:其他商業及管理學類
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:58
中文關鍵詞:論病例計酬臨床路徑資料探勘醫療品質
外文關鍵詞:case paymentclinical pathwaysdata miningmedical quality
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  • 下載下載:19
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臨床路徑(Clinical Pathways)主要是針對大部分的病患,由醫院的管理人員、醫師及護理人員,根據疾病制訂一套標準化的治療流程,使病患從住院到出院都根據此模式接受治療。但目前臨床路徑是以人工方式建立,並且需透過實施路徑的病患進行評估與分析,相當費時。因此,本研究以台灣某區域教學醫院就醫記錄為基礎的住院資料庫,並以區域教學醫院的住院病患為實證對象,首先以住院資料庫中,病患的住院天數求算各種疾病的住院天數比率,再計算疾病各項處置的執行機率及處置在各住院日的實施率,接著將住院天數、處置的執行機率及處置在各住院日的實施率的運算結果整合,以建立各種疾病的臨床路徑。本研究針對所有疾病建立適當的臨床路徑,經與健保局訂定之論病例計酬(case payment)的疾病做驗證,結果必要處置診療項目的總平均比率在81.82%以上,證明本研究方法所建立的臨床路徑是符合論病例計酬的處置項目。本研究結果可做為醫師制訂臨床路徑的依據,同時可提昇醫療品質、避免重覆性的診察及掌握患者的醫療需求。
Clinical Pathways mainly focus on general patients. A standard treatment process is established by professionals, doctors and nursing personnel in the hospital based on the disease to have patients accept treatments based on this model. However, the clinical pathways are currently established manually and the evaluation and analysis need to be processed through patients experiencing the pathways, which are rather time-consuming. The study adopted the hospitalization database on the basis of medical record of certain regional education hospital in Taiwan. First, the ratio of days staying in the hospital were calculated by various diseases among the hospitalization database, followed by calculation of execution possibility of different treatments and implementation rate of treatment at different days staying in the hospital. Next, integrate the results of days staying in hospital, execution possibility of treatments and implementation rate of treatments at different days staying in hospital to establish clinical pathways for various diseases. The study established appropriate clinical pathways aiming at different diseases. With verification of case payment stipulated by National Health Insurance Bureau, the results show that satisfied total ratio of necessary treatment items reached 81.82% which approves that the clinical pathways established by the study are satisfactory to the treatment items on the basis of case payment. The results of study are available for the doctors as basis to establish clinical pathways while enhancing the medical quality, avoiding repetitive diagnosis and controlling the medical needs of patients.
摘要 I
Abstract III
謝誌 V
目錄 VI
圖目錄 VIII
表目錄 IX
1 緒論 1
1.1 研究背景與動機 1
1.2 研究目的 2
1.3 研究流程與架構 3
2 文獻探討 4
2.1 資料探勘 4
2.2 資料探勘的應用 5
2.3 臨床路徑 6
2.4 臨床路徑的應用 7
2.5 小結 9
3 研究方法 10
3.1 問題定義 11
3.2 資料前置整理 12
3.3 住院天數比率 13
3.4 處置的執行機率 14
3.5 處置在各住院日的實施率 15
3.6 符合項目的人數比率 17
4 實證研究 20
4.1 研究工具與平台 20
4.2 論病例計酬疾病為驗證 21
4.3 驗證結果 24
4.4 非論病例計酬疾病 26
4.5 小結 29
5 結論 30
參考文獻 31
附錄 34
作者簡介 48

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