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題名:醫師臨終之醫療資源耗用:醫師病人是否不同?
書刊名:臺灣公共衛生雜誌
作者:連怡甄楊長興 引用關係
作者(外文):Lien, Yi-jenYang, Chiang-hsing
出版日期:2012
卷期:31:3
頁次:頁236-250
主題關鍵詞:生命末期知情消費者醫師病人同儕禮遇全民健保資料庫End stage of lifeInformed consumerPhysician-patientPeer courtesyNational Health Insurance Research DatabaseNHIRD
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(0) 博士論文(1) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:0
  • 共同引用共同引用:11
  • 點閱點閱:77
目標:比較醫師與一般民眾在生命末期之醫療資源耗用是否有差異,並探索影響醫師生命末期醫療資源耗用之因素。彌補醫師病人生命末期醫療資源利用是否有差異之研究缺口。方法:利用1999至2003死因資料檔與全民健康保險資料庫中基本資料檔及住院檔加密後串聯,以醫師性別、死亡年齡、原死因別進行1:10配對抽樣選出對照組樣本(一般民眾),並利用複迴歸以及邏輯斯迴歸比較醫師與一般民眾死亡前六個月住院醫療耗用以及特殊醫療利用是否有差異。結果:醫師死亡前六個月住院總醫療費用、每次住院醫療費用、加護病房利用率、加護病房總住院天數等,均顯著皆高於一般民眾。結論:醫師在生命末期時其醫療費用顯著高於一般民眾。醫師成為病人時角色既獨特且具挑戰性,他們的醫師可能基於情誼給與同儕禮遇,在挽留同儕生命所做的決策可能與照護一般民眾有異。
Objectives: To assess the differences in medical resource consumption at the end of life between physicians and the general public, and to explore possible reasons for this in order to help fill the gap in research on medical resource consumption by physician-patients at the end of life. Methods: The data were drawn from encrypted Death Registry and National Health Insurance claims from 1999 through 2003. A sample of the general public (the comparison group) was drawn at a ratio of 10:1 relative to the physician sample, and was matched by gender, age and primary cause of death. Both multivariable linear regression and logistic regression analyses were conducted to compare hospital care and specific services used in the six months prior to death by the two groups. Results: Total hospital care expenses, expenses per admission, the utilization rate of intensive care units, and the length of stay in the six months prior to death were significantly higher for physicians than for the general public. Conclusions: Physicians account for substantially higher expenses at the end of life than does the general public. Physicians, as unique and challenging patients, may influence their treating physicians to adopt special lifesaving strategies out of fellowship or courtesy.
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學位論文
1.Chen, S. I.(1998)。老人生命末期健保住院醫療費用之分析。國立陽明大學,台北。  延伸查詢new window
圖書
1.趙可式(2007)。醫師與生死。臺北:寶瓶文化事業有限公司。  延伸查詢new window
其他
1.Department of Health, Executive Yuan, R.O.C.。(ICD9)簡略死因分類碼,http://www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx?d=74452&s=1, 20110824。  new window
 
 
 
 
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