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身心障礙研究

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篇名 台灣地區智能障礙住院利用情形初探
卷期 11:1
並列篇名 Hospital Utilization by People with Intellectual Disability: Evidence from National Health Insurance Inpatient Expenditures Claims Database
作者 徐尚為張育嘉江博煌盧怡伶
頁次 001-015
關鍵字 住院智能障礙醫療利用Healthcare utilizationhospitalizationintellectual disabilities
出刊日期 201303

中文摘要

  目的:智能障礙者常合併其他障礙,因此對醫療的需求高於一般人口群,然而我國對於他們實際醫療利用之相關研究卻相當缺乏。因此本研究希望藉由分析健保資料庫來瞭解智能障礙者住院醫療利用情形,以及年齡別、投保區都市化程度、智障程度與部分負擔情形等變項與醫療利用情形之相關性。
  方法: 2007年全民健康保險住院資料、醫院資料與投保人資料以統計軟體SAS9.2 版進行串檔後,並依照國際疾病分類(ICD-9-CM)將智能障礙等級區分為輕度、中度、重度、極重度與未明示智能障礙等五類,探討就醫差異與相關性。
  結果:研究樣本共11,658人,其中男性6,967人,帄均27.4歲;女性4,691人,帄均32.1歲,帄均一年住院次數為1.6次。研究樣本每次住院帄均13.1日,每次住院申報45,328元;累積一年住院24.8日,年累積申報91,048元。老年人之年住院次數、每次住院申報費用與年累積申報費用,高於其它年齡層。輕度智障者之帄均住院次數、每次住院申報費用與年累積申報費用少於其他智能障礙等級者。重大傷病與低收入戶之年住院次數、每次住院申報費用與年累積申報費用,高於一般身分者。男性每次住院天數多於女性,但年累積年住院天數、每次住院費用與年累積年住院費用,男女間無差異。
  結論:本研究發現,智能障礙者之年帄均住院利用與耗用在智障等級、個案年齡、部分負擔情形以及投保地都市化程度等變項有所差異。但受限於全民健康資料庫定型化檔案限制,無法探討社經地位、婚姻情形、家庭狀況等因素與住院利用與耗用之相關性。

英文摘要

  Background/Purpose: To analyze and describe the patterns of cost of hospitalization and length of stay in people with intellectual disability.
  Methods: The 2007 National Health Insurance inpatient expenditures by admissions records of intellectual disability subjects were used to explore the usage of medical resources and influencing factors.
  Results: The average hospital admission was 1.6 times per year, subject older than 64 year-old had higher admissions record than other population. The average hospital expense per visit was 45328 NTD and length of stay was 13.1 days; average annual hospital expense and length of stay was 91048 NTD and 24.8 days. For claimants age older than 65 year old had longer length of stay, higher admission expenses than other groups. People suffering with moderate intellectual disability had shorter length of stay, fewer admission expenses than other groups. Subjects with major-illness and social warfare recipients had longer length of stay, higher admission expenses than full copayment groups. No gender difference in admission expenses.

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