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題名:全民健保腹膜透析比血液透析省錢嗎?
書刊名:臺灣公共衛生雜誌
作者:常逸平錢慶文楊耿如
作者(外文):Chang, Yi-PingChien, Ching-WenYang, Keng-Ju
出版日期:2007
卷期:26:5
頁次:頁400-408
主題關鍵詞:血液透析腹膜透析透析費用察爾森合併症嚴重度指標HemodialysisPeritoneal dialysisDialysis costCharlson comobidity index
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  • 被引用次數被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:0
  • 點閱點閱:90
目標:比較腹膜透析(PD)與血液透析(HD)患者在全民健保醫療資源 (費用) 的利用 (包括透析及非透析部份) 是否有所差異?同時亦分析性別、年齡、疾病嚴重度等變項對不同透析模式費用的影響。 方法:本研究為回溯性研究,利用全民健保資料庫篩選出2003至2005年間初次接受透析治療患者連續30個月之醫療費用資料進行統計分析。 結果:經分析結果共有2,407位初次透析患者,其中男性1,069人 (44.4%),女性1,338人 (55.6%);接受「HD」治療者2,189人 (90.94%);接受「PD」治療者218人 (9.06%)。透析患者的平均年齡以45至64歲的年齡層最多,佔所有研究對象之46.28%。患者之Charlson Index平均為5.06分。門診透析平均每人醫療費用PD為459,843元/年,HD為618,306元/年;門診非透析平均每人醫療費用PD為47,388元/年,HD為45,761元/年;住院透析平均每人醫療費用PD為9,504元/年,HD為18,981元/年;住院非透析平均每人醫療費用PD為37,531元/年,HD為40,712元/年。 結論:PD的門診及住院透析平均每人醫療費用均比HD低,並達到顯著性的差異 (p<0.001),惟PD患者的年齡與疾病嚴重度相對的比HD患者輕,而在門診及住院非透析費用部份,HD與PD則無顯著差異。
Objectives: To compare utilization of National Health Insurance (NHI) resources in terms of health expenses, including dialysis- and non-dialysis-related expenses, between hemodialysis (HD) and peritoneal dialysis (PD) patients. This study also analyzed the influence of different variables, such as gender, age, and disease severity, to two modalities of dialysis. Methods: This study was a retrospective study of new dialyzed patients and their health expenses between 2003 and 2005. Data were abstracted and analyzed from the inpatient /outpatient claim databases of the NHI for 30 consecutive months. Results: Two thousand four hundred seven patients were included in this study; 1,069 (44.4%) were males and 1,338 (55.6%) were females. Two thousand one hundred eighty-nine patients (90.94%) were classified as the “HD” group and two hundred eighteen patients (9.06%) were classified as the “PD” group. Most patients belonged to the 45-64 age group (46.28% of the total sample). The average Charlson Index was 5.06. The average individual outpatient dialysis expense in the PD group was NT$459,843/year and NT$618,306/year for the HD group. The average individual outpatient non-dialysis expense in the PD group was NT$47,388/year and NT$45,761/ year for the HD group. The average individual inpatient dialysis expense in the PD group was NT$9,504/year and NT$18,981/year for the HD group. The average individual inpatient non-dialysis expense in the PD group was NT$ 37,531/year and NT$40, 712/year for the HD group. Conclusions: The individual outpatient and inpatient dialysis-related expenses of the PD group were significantly less expensive than the HD group (p<0.001). However, PD patients were younger and had milder disease severity than the HD patients. There were no significant differences in outpatient and inpatient No-ndialysis-related expenses between the PD and HD groups.
期刊論文
1.Kalo, Z.、Jaray, J.、Nagy, J.(2001)。Economic evaluation of kidney transplantation versus hemodialysis in patients with end-stage renal disease in Hungary。Prog Transplant,11,188-193。  new window
2.Winkelmayer, W. C.、Weinstein, M. C.、Mittleman, M. A.、Glynn, R. J.、Pliskin, J. S.(2002)。Health economic evaluations: the special case of end-stage renal disease treatment。Med Decis Making,22,417-430。  new window
3.Shih, Y. C.、Guo, A.、Just, P. M.、Mujais, S.(2005)。Impact of initial dialysis modality and modality switches on medicare expenditures of end-stage renal disease patients。Kidney Int,68,319-329。  new window
4.Panagoutsos, S.、Kantartzi, K.、Passadakis, P.(2006)。Timely transfer of peritoneal dialysis patients to hemodialysis improves survival rates。Clin Nephrol,65,43-47。  new window
5.Lee, H.、Manns, B.、Taub, K.(2002)。Cost analysis of ongoing care of patients with end-stage renal disease: the impact of dialysis modality and dialysis access。Am J Kidney Dis,40,611-622。  new window
6.Alloatti, S.、Manes, M.、Paternoster, G.、Gaiter, A. M.、Molino, A.、Rosati, C.(2000)。Peritonal dialysis compared with hemodialysis in the treatment of end-stage renal disease。J Nephrol,13,331-342。  new window
7.Bruns, F. J.、Seddon, P.、Saul, M.、Zeidel, M. L.(1998)。The cost of caring for end-stage kidney disease patients: an analysis based on hospital financial transaction records。J Am Soc Nephrol,9,884-890。  new window
8.Song, Y. S.、Jung, H.、Shim, J.、Oh, C.、Shin, G. T.、Kim, H.(2007)。Survival analysis of Korean end-stage renal disease patients according to renal replacement therapy in a single center。J Korean Med Sci,22,81-88。  new window
9.McMurray, S. D.、Miller, J.(1997)。Impact of capitalization on free-standing dialysis facilities: can you survive。Am J Kidney Dis,30,542-548。  new window
10.Collins, A. J.、Kasiske, B.、Herzog, C.(2007)。USRDS(The United States Renal Data System) 2006 ADR: international comparisons。Am J Kidney Dis,49,223-234。  new window
11.黃尚志、楊五常、陳秀熙(2000)。暨中華民國腎臟醫學會透析評估委員-台灣地區八十八至八十九年度透析評估工作報告。臺腎醫誌,14(4),139-228。  延伸查詢new window
12.Hooi, L. S.、Lim, T. O.、Goh, A.(2005)。Economic evaluation of centre haemodialysis and continuous ambulatory peritoneal dialysis in Ministry of Health hospitals, Malaysia。Nephrology,10,25-32。  new window
13.Peeters, P.、Rublee, D.、Just, P. M.、Joseph, A.(2000)。Analysis and interpretation of cost data in dialysis: review of western European literature。Health policy,54,209-227。  new window
14.Miskulin, D. C.、Meyer, K. B.、Athienites, N. V.(2002)。Comorbidity and other factors associated with modality selection in incident dialysis patients: the CHOICE study。Am J Kidney Dis,39,324-336。  new window
學位論文
1.鄭振廷(2003)。末期腎臓疾病病患定期血液透析醫療費用分析研究(碩士論文)。國立陽明大學。  延伸查詢new window
2.謝桂貞(2005)。氣喘處方型態與醫療照護利用的關係(碩士論文)。國立臺灣大學。  延伸查詢new window
3.張碧玉(2000)。勞動人口慢性透析病患疾病成本分析(碩士論文)。國立成功大學。  延伸查詢new window
圖書
1.李希敏(2004)。人工腎(透析)服務裝置之市場現況與趨勢。台北:經濟部。  延伸查詢new window
其他
1.台灣腎臓醫學會。台灣腎臟醫學會2004透析年度報告,http://www.tsn.org.tw, 2007/05/18。  延伸查詢new window
 
 
 
 
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