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題名:心臟復健對急性心肌梗塞病患復發率,死亡率與醫療費用之影響
作者:陳惠文
作者(外文):CHEN, HUI-WEN
校院名稱:輔仁大學
系所名稱:商學研究所博士班
指導教授:陳銘芷
劉志光
學位類別:博士
出版日期:2016
主題關鍵詞:急性心肌梗塞醫療費用復發率死亡率心臟復健acute myocardial infarctiomedical costrecurrencemortalitycardiac rehabilitation
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冠心病是最常見的心臟疾病,其中最嚴重的就是急性心肌梗塞。心臟復健可以改善心肺功能,對心臟病的危險因子有正向的影響。本研究的目的是探討心臟復健對急性心肌梗塞復發率、死亡率與醫療費用的影響。利用2000-2010 年國衛院提供全民健保門診處方及治療明細檔、門診處方醫令明細檔、住院醫療費用清單明細檔及住院醫療費用醫令清單明細檔,研究樣本共 834 人,我們將樣本分為兩組,實驗組為有接受復健治療者,對照組為沒有接受復健治療者,結果發現實驗組有較低的急性心肌梗塞復發率(Hazards ratio=0.64,95% confidence interval=0.197-1.863;p=0.004),及較低的心血管相 關 疾 病 死 亡 率 (Hazards ratio=0.859 , 95% confidence interval=0.609-1.007;p=0.037),實驗組比對照組有較低的心血管相關疾病門急診醫療費用(Hazards ratio=0.947,95% confidence interval=0.934-0.981;p=0.042),故有進行心臟復健對急性心肌梗塞病患有助益。醫院管理單位應加強對病患及相關醫療人員的衛教,宣導進行心臟復健的好處,提倡早期復健以提高醫療資源利用之效率。
Coronary heart disease is the most frequently occurring heart disease, of which acute myocardial infarction (AMI) is one of the most severe. Cardiac rehabilitation can improve cardiopulmonary function and positively affects risk factors for heart disease. The purpose of this study is to evaluate the recurrence, mortality and medical cost after acute myocardial infarction following cardiac rehabilitation. We analyzed Taiwan’s 2000-2010 National Health Insurance Research Database (NHIRD). A total of 834 subjects with acute myocardial infarction were divided into group 1 (with cardiac rehabilitation) and group 2 (without cardiac rehabilitation). The results revealed that the group 1 had lower acute myocardial infarction recurrence, the Hazard ratio by 0.640-fold (95% CI, 0.197-1.863; P=0.004) than the group 2, respectively. The group 1 had lower mortality, the Hazard ratio by 0.859-fold (95% CI, 0.609-1.007; P=0.037) than the group 2. The group 1 also had lower medical cost, the Hazard ratio by 0.947-fold (95% CI, 0.934-0.981; P=0.042) than the group 2. The findings have implications for clinicians and decision-making for health policymakers attempting to provide adequate services for patients after acute myocardial infarction.
中文部分
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7.常逸平,「腹膜透析比血液透析便宜嗎?以初次接受透析治療患者醫療資源耗用為例」,台灣衛誌,26期(5),2007年,頁400-408。
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10.賴文源,「急性心肌梗塞」,當代醫學,39期(3),2012年,頁221-229。

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