目的：探討全民健保制度下髖關節置換手術之醫療利用與費用情形。方法：資料得自全民健康保險學術研究資料庫，採用民國86年7月至87年6月（簡稱為86年度）及民國91年7月至92年6月（簡稱為91年度）之住院醫療費用清單明細檔及醫事機構基本資料檔作比較。結果：91年度髖關節置換手術人次較86年度增加22.6%（p<0.001；各有10961及13441人），平均年齡約增加3-4歲。全髖關節置換手術及髖關節再置換手術者皆以60-69歲及男性居多，其中全髖關節置換手術者之手術原因以骨及軟骨之其他疾病與骨關節病及相關疾病為主，髖關節再置換手術者以某些明示手術所致之獨特併發症居多。半髖關節置換手術者之手術人次及費用比例皆為三者中最高，且以高齡（70-79歲）、女性居多，其手術原因以跌倒事故所致股骨頸骨折為大宗。髖關節置換手術之總醫療費用由12.8億成長至15.6億，約增加22.0%。結論：全民健保實施後各項髖關節置換手術人次及總醫療費用上升，並以女性、老年人及事故原因為跌倒者增加較顯著，未來應注重預防老人骨質疏鬆、跌倒，以降低醫療負擔。

Purpose: The objective of this study was to compare the incidence rate, cost and subject characteristics of total hip replacement (THR), partial hip replacement (PHR), and revision of hip replacement (RHR) between annual year 1997 (from July 1, 1997 to June 30, 1998) and annual year 2002 (from July 1, 2002 to June 30, 2003) under the National Health Insurance (NHI) program in Taiwan. Method: The registry for contracted medical facilities (HOSB files) and the inpatient expenditures by admissions data files (DD files) in annual year 1997 and 2002 offered by National Health Research Institutes were analyzed in this study. The research variables included operation type, age, gender, causes of operation, external causes if provided, the accreditation level of executing hospitals and cost. Results: The incidence of hip replacement significantly increased by 22.6% between 2 annual years (p<0.001; 10961 cases and 13441 cases in annual year 1997 and 2002, respectively). The total medical costs increased by 22.0% between 2 annual years (1.28 billion and 1.56 billion in annual year 1997 and 2002, respectively). The average operation age of THR and PHR significantly increased by 3 to 4 years (p<0.001), but that of RHR didn't. The incidence rate and cost of PHR were highest among hip replacements. Among subjects undergone PHR, elderly (especially at the 70-79 age group) and female were most common. The main causes of PHR were fracture of neck of femur (ICD9CM_CODE: 820; 69.5% and 76.0% in annual year 1997 and 2002, respectively) and fall (Ecoed: E885 and E888; 61.6% and 68.7% in annual year 1997 and 2002, respectively). Among subjects undergone of THR and RHR, the 60-69 age group was most common. In contrast with PHR, more males underwent THR and RHR than females. The major causes of THR were mainly other disorders of bone and cartilage (ICD9CM_CODE: 733; 47.9% and 46.0% in annual year 1997 and 2002, respectively) and osteoarthrosis and allied disorders (ICD9CM_CODE: 715; 38.2% and 42.8% in annual year 1997 and 2002, respectively). The major cause of RHR was complications peculiar to certain specified procedures (ICD9CM_CODE: 996; 77.2% and 83.8% in annual year 1997 and 2002, respectively). Conclusion: The incidence and total cost of hip replacements increased substantially between annual year 1997 and annual year 2002. The increment seemed more significantly in female, elderly and people with fall as an external cause. We should focus prevention of age-related osteoporosis, fall problem in elderly to decrease the medical burden.