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研究生:林品瑜
研究生(外文):Ping-Yu Lin
論文名稱:2011年台灣地區憂鬱症患者使用全民健保之費用分佈
論文名稱(外文):The distribution of National Health Insurance costs for depression disorder in Taiwan in 2011
指導教授:林麗芬林麗芬引用關係
口試委員:陳甫州林敬恒
口試日期:2015-06-29
學位類別:碩士
校院名稱:逢甲大學
系所名稱:統計學系統計與精算碩士班
學門:數學及統計學門
學類:統計學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:40
中文關鍵詞:憂鬱症全民健保資料庫醫療費用
相關次數:
  • 被引用被引用:6
  • 點閱點閱:309
  • 評分評分:
  • 下載下載:62
  • 收藏至我的研究室書目清單書目收藏:2
憂鬱症,又稱心靈的感冒,為現代人面臨的重大疾病之一,許多人因為不了解憂鬱症的症狀加上社會歧視所造成的心理壓力,而未尋求醫治。世界衛生組織指出,在2020年憂鬱症將會變成第二大疾病,甚至在已開發國家中,憂鬱症的排名可能會躍居第一位,對於醫療費用將有重大的影響。
本研究使用台灣全民健康保險資料庫承保抽樣檔,以主診斷碼為憂鬱症的患者為觀察對象,觀察台灣近10年(2002年至2011年)的憂鬱症年盛行綠及費用趨勢。針對2011年憂鬱症患者的就醫紀錄來做研究,將每位憂鬱症患者醫療使用之總費用升冪排序,並等分割成10個分位數。利用單因子變異數分析及交叉分析,進一步探討不同病患屬性及就醫行為模式下醫療費用之差異。
結果顯示,2002年至2011年台灣憂鬱症患者的年盛行綠是持續增加的,自1.33%成長至2.13%,總醫療費用也是持續增加的,10年來成長了84%,在2011年時達到新台幣2.72億元。探討2011年分組結果,總共有17,429人登記120,167筆憂鬱症診斷的就醫紀錄,發現第十組的總醫療費用顯著大於其他九組。在費用最高的10%患者中,選擇使用醫療資院之次數比例較多的顯著特徵為:重鬱症、女性、40至59歲之間、選擇精神科就診、選擇區域醫院就醫、就診次數0至9次者。每次就醫平均醫療費用較高者為:輕度憂鬱症、男性、使用住院醫療資源、選擇醫學中心就醫,就診次數10次以上者。本研究結果可供健保或醫療保險政策改變時參考。
Depression, also has a common name the cold of mind, is one of the major diseases that modern people should face. Most of patients give up to search for a treatment because the misunderstanding and the social discrimination. World Health Organization noted that depression will be the second serious disease when the time goes to 2020; what’s more, it is not only be ranked at first in the developed countries but also bring up a negative effect for the costs for medical treatment.
In this study, we use the Taiwan National Health Insurance Research Database to the primary diagnosis code is depression’s patients as the objection to observe. Also find the Taiwan National Health Insurance Research Database of nearly 10 years (2002-2011) that the development of depression and the cost trends. Then the study is against to do the research on patients’ medical records depression on 2011. According to the total cost of medical using by patients, we divided by the population into 10 equal size groups from the low to high for analysis. Using one-way analysis of variance, Cross Analysis, explore the attribute and behavior of the patients differences in medical costs.
The prevalence of depression was increased from 1.33% in 2002 to 2.13% in 2011, and costs associated increased similar of 84% for 10 years, and it were been reached to NTD 272 millions in 2011. Explore into 10 equal size groups in 2011, there were 17,429 peoples and 120,167 records that had visit for depression. We find the costs increased substantially in the last decile than the others decile. Analysis for the characteristic of the last decile which medical treatment was the most commonly used is major depressive disorder, woman, 40-59 years old, psychiatrist, metropolitan hospitals and used 0-9 times service. The cause of higher medical costs of the last decile is neurotic depression, man, hospitalized, academic medical centers and used at least 10 times service. The research result will be able to provide reference to change the medical insurance policy or National Health Insurance.
第一章 緒論 1
第一節 研究動機 1
第二節 研究背景 2
第三節 研究目的 4
第二章 研究設計與方法 5
第一節 研究流程圖 5
第二節 資料來源 6
第三節 研究方法 8
第三章 資料分析與研究結果 11
第一節 2002年至2011年憂鬱症趨勢 11
第二節 2011年憂鬱症費用分組分析 13
第四章 討論與建議 18
第一節 2002至2011年台灣憂鬱症趨勢討論 18
第二節 2011年憂鬱症患者使用醫療資源狀況及費用結果討論 18
第三節 台灣與加拿大阿爾伯塔省醫療制度討論 19
第四節 台灣商業保險狀況討論 20
第五節 研究限制與建議 20
參考文獻 31
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