目標：探討申報物理治療之住院病患疾病分類的情形，並比較不同層級醫療院所病患之診斷數、排序、診療項目和平均治療次數的差異。方法：由國家衛生研究院全民健康保險學術研究資料庫測試版，計算各層級醫療院所申報物理治療的診斷數，並做主診斷的排序。再以首位之腦動脈阻塞為例，探討不同層級醫療院所物理治療診療項目與平均治療次數。結果：本資料庫之申報物理治療的總人次與總金額，分別佔申報總數的0.4%及0.1%：患者之疾病診斷數在各層級醫療院所有顯著差異（p= 0.001），醫學中心以單一診斷比例較高；以治療人次計，主診斷的排名在各層級醫療院所略有不同，但皆以腦動脈阻塞居首位，而「復健療養」在所有申報中名列第八；診療項目在醫學中心和區域醫院以複雜治療項目為主，而地區醫院則以「簡單－中度」治療為大宗，具明顯差異（p<0.0l），但各層級醫療院所申報之病人平均治療次數則無明顯不同（p=0.39）。結論：國際疾病分類碼並不能有效釐清和分類物理治療的使用及其適切性，應推展物理治療診斷、評估與紀錄。

Objectives: The purposes of this study were to investigate theinpatients' distribution and payment items in physical therapy utilization by International Classification of Disease coding and compare thedifferences among different levels of health care institutions Methods: The
information released by National Health Institute was used in this study. The number of diagnosis per patient and the ranking of primary diagnosis were analyzed. Chi-square analysis and one-way ANOV: were used to compare the payment items and average number of treatment sessions for the leading diagnosis (occlusion of cerebral arteries) in different levels of health care institutions. Results: The frequency and expenditure of physical therapy utilization were 0.4% and 0.1 % of the total amount respectively. The number' of diagnosis was significantly different among the different levels of health care institutions (p=0.001), more patients had only one diagnosis in medical centers. The ranking of primary diagnosis was different in different levels of health care institutions, however, occlusion of cerebral arteries was the leading diagnosis for all the levels. The payment items were significantly different among the different levels of health care institutions (p<0.01), however, the average of treatment sessions was not (p>0.05). Conclusions: Physical therapy diagnosis, evaluation and documentation are needed to improve the quality of classifying physical therapy utilization in addition to adopting international classification of disease coding.