臺灣博碩士論文加值系統

背景：輪狀病毒是引起5歲以下孩童嚴重腸胃炎及脫水的
主要原因，不論是在已開發或開發中國家，孩童
輪狀病毒感染情形皆非常普遍，造成龐大的疾病
及經濟負擔。為了評估疫苗之潛在價值，必須要
先了解國內每年輪狀病毒感染所造成之疾病及經
濟負擔。

目的：估計台灣地區因小兒輪狀病毒感染住院所造成之
經濟負擔，作為實施疫苗相關接種策略之參考。

方法：以2001年4月至2003年3月間，台灣大學醫學院附
設醫院、台北榮民總醫院、台中榮民總醫院、高
雄榮民總醫院四家醫院5歲以下因腹瀉而住院之孩
童為對象，共2,600名個案。利用四家醫院填寫之
通報資料計算其醫療費用（包括健保給付額及自
付額），並利用問卷資料估計其除了醫療費用外
其餘相關花費（交通費、薪資損失、其他醫療、
雜項支出），計算其所造成之社會成本、私人成
本、直接成本及間接成本。並利用90-92年之健保
資料庫計算全國5歲以下因腹瀉而住院之孩童人
數，從中估計輪狀病毒感染住院之人數，將2,600
名樣本所計算出之結果推估至全國。

結果：輪狀病毒每年約造成12,000-15,000名5歲以下孩
童住院，平均每個5歲以下因感染輪狀病毒而住院
之孩童所造成之個人社會成本為30,166元，私人
成本為16,806元，直接成本為23,681元，間接成
本為6,485元。每年所造成之社會成本為3.6-4.6
億元，私人成本為2-2.6億元，直接成本為2.8-
3.6億元，間接成本為0.76-1億元。當家中有孩童
因輪狀病毒感染而住院時，平均家庭直接支出為
10,321元。
結論：輪狀病毒在台灣造成大量之疾病負擔及經濟負
擔，安全且有效之疫苗在預防輪狀病毒感染上是
需要的。

Background：Rotavirus is the leading cause of
serve gastroenteritis and
dehydration among children ＜5 years
old. The rotavirus infection is
common in both developed and
developing nations among children,
which caused substantial diseases
and economic burden. In order to
assess the potential value of
rotavirus vaccines, we must
understand the diseases and economic
burden caused by rotavirus annually
in Taiwan.

Objective：To estimate the economic burden of
hospitalization caused by rotavirus
for future vaccination strategies in
Taiwan.

Method：The study objectives were 2600
hospitalized diarrhea children who under
five years old at four hospitals
(National Taiwan University Hospital,
Taipei Veteran General Hospital,
Taichung Veteran General Hospital and
Kaohsiung Veteran General Hospital) from
1 April, 2001 to 31 March, 2003 in
Taiwan. The case report form these four
hospitals was used to calculate the
medical costs（including the costs of
NHI and copayment）and self-reported
questionnaires was used to estimate the
other related costs（travel costs, lost
wages, other medical costs and other
related costs）and to calculate the
social costs, private costs, direct
costs and indirect costs. National
Health Insurance Research Database was
used to estimate the number of
hospitalized rotavirus infection
children cased by diarrhea during 2001
and 2003 in Taiwan. Then the result of
2600 study objectives will be
generalized to the nation.

Result：Rotavirus causes 12,000~15,000
hospitalizations per year among children
＜5 years old. On average, the social
cost was NT $30,166 per case, the
private cost was NT $ 16,806 per case,
the direct cost was NT $23,681 per case,
and the indirect cost was NT $ 6,485 per
case. The total annual social cost was
about NT $360~460 million, the total
annual private cost was about NT
$200~260 million, the total annual
direct cost was about NT $ 280~360
million, and the total annual indirect
cost was about NT $76~100 million. On
average, each family spent NT $10,321
once their child was hospitalized with
rotavirus infection.

Conclusion：Rotavirus caused substantial
diseases and economic burden in
Taiwan. To prevent the rotavirus
infection, a safe and effective
vaccine is needed.

第一章　緒論
一、研究背景------------------------------------------------------1
二、研究目的------------------------------------------------------2
第二章 文獻探討
一、輪狀病毒概述--------------------------------------------------3
二、輪狀病毒造成之疾病負擔----------------------------------------6
三、輪狀病毒所造成之經濟負擔-------------------------------------10
四、輪狀病毒疫苗-------------------------------------------------11
五、疾病成本（Cost-of-illness，COI）分析-------------------------12
第三章　研究方法
第一部分　5歲以下孩童因輪狀病毒感染住院所造成之經濟負擔
　　一、研究對象-------------------------------------------------17
　　二、資料來源及內容-------------------------------------------17
　　三、計算方式-------------------------------------------------22
第二部分　民國85－92年全國腹瀉住院人次、日數及醫療費用變化趨勢
　　一、資料來源-------------------------------------------------23
　　二、研究對象-------------------------------------------------23
　　三、統計分析-------------------------------------------------23
第四章　研究結果
　　　　第一部分　5歲以下孩童因輪狀病毒感染住院所造成之經濟負擔
　　一、四家醫院通報個案之個人成本-------------------------------24
　　二、四家醫院通報個案之總成本---------------------------------25
　　　　　　三、個人成本佔平均國民所得（GNI）之百分比--------------------26
　　　　　　四、輪狀病毒感染住院之全國總成本-----------------------------27
第二部分 民國85-92年全國腹瀉住院人次、日數及醫療費用變化趨勢
一、全國腹瀉住院變化趨勢-------------------------------------29
二、全國小兒科腹瀉住院變化趨勢-------------------------------29
三、全國小兒科5歲以下腹瀉住院變化趨勢------------------------30
第五章　討論
　　　　一、各國醫療費用比較---------------------------------------------32
二、研究樣本估計偏差---------------------------------------------32
二、預防輪狀病毒感染之重要性及策略-------------------------------33
第六章 參考文獻---------------------------------------------------------35

附錄一　幼童急性腸胃炎個案通報單-----------------------------------------71
附錄二　幼童急性腸胃炎相關花費明細問卷-----------------------------------72
附錄三　健保資料庫住院醫療費用清單明細檔---------------------------------76

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