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研究生:陳佩欣
研究生(外文):CHEN PEI-HSIN
論文名稱:智能障礙者罹患感染性皮膚疾病之門診醫療利用情形
論文名稱(外文):The Exploration of Medical Resources Utilization in the Intellectual Disabilities with Skin Infections
指導教授:徐尚為徐尚為引用關係
指導教授(外文):Shang-Wei Hsu
口試委員:徐尚為林富宮董和銳
口試委員(外文):Shang-Wei HsuFu-Gong LinHo-Jui Tung
口試日期:2013-06-04
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:2013
畢業學年度:101
語文別:中文
論文頁數:100
中文關鍵詞:智能障礙者感染性皮膚疾病門診醫療利用
外文關鍵詞:intellectual disabilityskin infectionmedical resource utilization
相關次數:
  • 被引用被引用:1
  • 點閱點閱:333
  • 評分評分:
  • 下載下載:49
  • 收藏至我的研究室書目清單書目收藏:0
目標:智能障礙者為身心障礙類別的其中一類,因健康情況差導致有較高的罹病率,許多研究指出智能障礙者在皮膚疾病盛行率相較於一般人高。本研究利用全民健保資料庫分析,初探智能障礙者罹患感染性皮膚疾病之影響因素與門診醫療利用情形。

方法:本研究資料採次級資料分析,申請國家衛生研究院2004年至2007年全民健康保險資料庫中門診處方及治療明細檔、承保資料檔與醫事機構基本資料檔等檔案做個人歸戶串聯,擷取ICD-9-CM診斷碼為317-319之保險人為研究對象,分析渠等罹患細菌感染、病毒感染、黴菌感染與寄生蟲之因素與門診醫療利用情形。

結果:台灣地區2004年至2007年智能障礙者罹患感染性皮膚疾病的盛行率為14.9%至16.92%,其平均年齡為26歲,罹患感染性皮膚疾病者每人每年平均就醫次數為2.79次至2.92次,每人每年門診醫療平均費用花費1,575.07元至1,632.13元各項感染性皮膚疾病盛行率以皮癬菌症之盛行率為最高,其次為蜂窩性組織炎。2004年至2007年就醫次數分佈發現,智能障礙者罹患感染性皮膚疾病好發於夏季,以七月至八月的就醫次數較高。二元邏輯斯迴歸分析智能障礙者罹患感染性皮膚疾病之風險預測因素顯示,年齡65歲以上者、低收入戶者與偏遠地區者罹患感染性皮膚疾病的風險高。影響智能障礙者罹患感染性皮膚病門診醫療利用之線性迴歸分析中,以年齡、部分負擔為主要因素。

結論:本研究初步探討智能障礙者罹患感染性疾病之門診醫療利用情形及各皮膚疾病門診就醫概況分佈,而智能障礙者罹患感染性皮膚疾病最常到基層院所就診,建議衛生單位訂定因應措施來預防感染性皮膚疾病,並且須注意智能障礙者的皮膚保持清爽乾燥、個人居家衛生及環境整潔,以提高智能障礙者的生活品質。
Purpose: Several studies had confirmed that people with intellectual disabilities have high prevalence rates of skin disease than general population. This research used the National Health Insurance Research Database to explore the skin infections risk factors of intellectual disabilities and medical resources utilization of skin infections.

Methods: Three National Health Insurance Research Database, ambulatory care expenditures by visits records, registry for beneficiaries records and registry for contracted medical facilities records from 2004 to 2007 were merged, and people with ICD-9 317-319 codes were selected as study subjects. The risks of been infected by bacteria, virus, fungus and parasites of study population and medical resources utilization were studied.

Results: From 2004 to 2007, the prevalence rates of skin infections of the intellectual disability were 14.9% ~ 16.92%, the average number of outpatient visits were 2.79 ~ 2.92, and the average annual medical cost to treat skin infections were NT$1,575.07 ~ NT$1,632.13. The most popular skin infections was dermatophytosis, the second one was cellulitis, and from July to August had the highest ambulatory visits.Through logistic regression analysis, subjects 65 years and older, low-income and lived in remote area had higher risk in skin infections. Results of linear regression analysis showed that medical resources utilization of skin infections affected by age group and copayment status. Local clinics were the major medical facilities for the intellectual disabilities to treat skin infections.

Conclusions: This study revealed medical resources utilization of skin infections by the intellectual disabilities. The elderly, low-income family and resided in remote area were more likely had skin infection problem, and the prevalence rate was increase yearly. Proper health education to individual and primary care giver is important to avoid skin infection problems.
中文摘要
英文摘要
目 錄 I
表 目 錄 III
圖 目 錄 V
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 智能障礙者 4
第二節 感染性皮膚疾病 11
第三節 醫療資源利用理論 16
第三章 研究方法 21
第一節 研究架構 21
第二節 研究假說 21
第三節 名詞解釋 22
第四節 研究變項之操作型定義 23
第五節 研究對象與資料來源 25
第六節 統計分析方法 27
第四章 研究結果 29
第一節 描述性統計分析 29
第二節 雙變項分析 34
第三節 多變項分析 41
第五章 討論 48
第一節 研究對象之人口特性 48
第二節 台灣智能障礙者罹患感染性皮膚疾病之盛行率 52
第三節 影響智能障礙者罹患感染性皮膚疾病之重要因素討論 55
第四節 影響智能障礙者罹患感染性皮膚病門診醫療利用重要因素討論 57
第六章 結論 60
第一節 結論 60
第二節 研究限制 62
第三節 建議 63
參考文獻 64
附錄 73
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1. 謝明娟、文久美、楊美雪(1998)門診病患對醫院滿意度與重視度之調查以台灣地區區域醫院為例。嘉南學報(24),183-193。
2. 蔡艷清、羅慶徽、蘇麗英、林金定(2006)。智能障礙者健康檢查異常率:罹患皮膚病概況分析。身心障礙研究,4(3&4),181-187。
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