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題名:精神分裂症病患三種社區精神復健模式之醫療利用分析
書刊名:臺灣職能治療研究與實務雜誌
作者:吳希文楊銘欽
作者(外文):Wu, Hsi-wenYang, Ming-chin
出版日期:2012
卷期:8:1
頁次:頁1-14
主題關鍵詞:精神病患社區復健成效康復之家差異中之差異法傾向分數Psychiatric patientEffects of community rehabilitationHalf-way houseDifference in difference methodPropensity score
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(3) 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:3
  • 共同引用共同引用:0
  • 點閱點閱:49
目的:本研究之目的在探討精神分裂症病患接受社區復健中心、康復之家治療後之住院醫療利用及其影響因素。方法:以「2002-2007精神疾病住院病患歸人檔」中擷取2006年精神分裂病患,自精神科住院出院後一年期間,連續接受30日以上社區復健中心治療者203人、接受康復之家治療者196人,及接受精神科門診追蹤者1631人為研究對象。以卡方檢定、檢定、one-way ANOVA、差異中之差異法、複迴歸等方法進行分析,另以傾向分數分析法校正選樣誤差。結果:以差異中之差異法分析,相較僅接受門診追蹤者,曾接受社區復健中心治療者,結束治療後一年期間精神科住院精神醫療治療費每人淨減少4.64千元,結束治療後二年期間精神科住院精神醫療治療費每人淨減少6.86千元。而影響病患社區精神復健成效的因素有年齡、性別、前一年精神科住院日數、非精神科住院日數、非精神科住院之總醫療費用、社區精神復健機構之權屬別、是否跨區接受社區精神復健治療,以及接受社區精神復健的時間長短等。結論:精神分裂症病患出院後曾接受社區復健中心治療者,其結束治療後一年及二年期間精神科住院之精神醫療治療費較接受門診追蹤者低;然接受康復之家治療者僅於其結束治療後一年期間精神科住院之精神醫療治療費較接受門診追蹤者低。
Objective: The aim of this research was to examine the effects of community rehabilitation centers or half-way houses on medical care utilization for patients with schizophrenia and related factors. Methods: We used the 2002-2007 Psychiatric Inpatients Medical Claims Data from the National Health Research Institute to extract 203 schizophrenic patients who discharged from psychiatric hospitalization in 2006 and continuously received treatment for more than 30 days in community rehabilitation centers within 1 year and 196 schizophrenic patients in half-way houses. We also included 1631 schizophrenic patients who discharged from psychiatric hospitalization within 1 year and only received psychiatric outpatient follow-ups. Data were analyzed by using, -test, one-way ANOVA, difference in difference, and multiple regressions. We also used propensity score matching to adjust for selection bias. Results: Compared with patients who received only psychiatric outpatient follow-ups, the net psychiatric medical expenditure decreased NT$4641.18 during the first year follow-up and decreased NT$6856.95 during the second year follow-up in patients who received treatment from community rehabilitation centers.The influences factors of the effects of community rehabilitation service were age, gender, psychiatric length-of-stay, non-psychiatric length-of-stay, non-psychiatric medical expenditure 1 year before receiving treatment, ownership of community psychiatric rehabilitation institutions, received community psychiatric rehabilitation services from institutions outside the region of residency, and the duration of treatment received. Conclusion: Compared with patients who received only psychiatric outpatient treatment, patients who received treatment from community rehabilitation centers had lower psychiatric medical expenditure in one and two-year follow-ups. Patients who received treatment from half-way houses had lower psychiatric medical expenditure in one-year follow-up.
期刊論文
1.Baca-Garcia, E.、Perez-Rodriguez, M. M.、Basurte-Villamor, I.、Quintero-Gutierrez, F. J.、Sevilla-Vicente, J.、Martinez-Vigo, M. et al.(2008)。Patterns of mental health service utilization in a general hospital and outpatient mental health facilities: Analysis of 365, 262 psychiatric consultations。European Archives of Psychiatry and Clinical Neuroscience,258(2),117-123。  new window
2.Barry, K. L.、Blow, F. C.、Dornfeld, M.、Valenstein, M.(2002)。Aging and schizophrenia: Current health services research and recommendations。Journal of Geriatric Psychiatry and Neurology,15(3),121-127。  new window
3.Dor, I. A.-B.、Savaya, R.(2007)。Community rehabilitation for persons with psychiatric disabilities: Comparison of the effectiveness of segregated and integrated programs in Israel。Psychiatric Rehabilitation Journal,31(2),139-148。  new window
4.Feinson, M. C.、Popper, M.(1995)。Does affordability affects mental health utilization? A United States-Israel comparison of older adults。Social Science and Medicine,40(5),669-678。  new window
5.Junghan, U.、Brenner, H.(2006)。Heavy use of acute in-patient psychiatric services: The challenge to translate a utilization pattern into service provision。Acta Psychiatrica Scandinavica Supplementum,429,24-32。  new window
6.Kent, S.、Yellowlees, P.(1995)。The relationship between social factors and frequent use of psychiatric services。Australian and New Zealand Journal of Psychiatry,29,403-408。  new window
7.Linn, M. W.、Caffey, E. M.、Klett, C. J.、Hogarty, G. E.、Lamb, H. R.(1979)。Day treatment and psychotropic drugs in the aftercare of schizophrenic patients。Archives of General Psychiatry,36,1055-1066。  new window
8.McDonald, M.、Hertz, R.、Lustik, M.、Unger, A.(2005)。Healthcare spending among community-dwelling adults with schizophrenia。American Journal of Managed Care,11(8),242-247。  new window
9.Nakanishi, M.、Setoya, Y.、Kodaka, M.、Makino, H.、Nishimura, A.、Yamauchi, K. et al.(2007)。Symptom dimensions and needs of care among patients with schizophrenia in hospital and the community。Psychiatry and Clinical Neurosciences,61(5),495-501。  new window
10.Padgeet, D. K.、Patrick, C.、Burns, B. J.、Schlesinger, H. J.(1994)。Ethnic differences in use of inpatient mental health services by Blacks, Whites, and Hispanics in a national insured population。Health Services Research,29(2),135-153。  new window
11.Sajatovic, M.、Sultana, D.、Bingham, C.、Buckley, P.、Donenwirth, K.(2002)。Gender related differences in clinical characteristics and hospital based resource utilization among older adults with schizophrenia。International Journal of Geriatric Psychiatry,17(6),542-548。  new window
12.Shek, E.、Stein, A. T.、Shansis, F. M.、Marshall, M.、Crowther, R.、Tyrer, P.(2009)。Day hospital versus outpatient care for people with schizophrenia。Cochrane Database of Systematic Reviews (Online),4。  new window
13.Stern, M. S.(1977)。Factors in the utilization of mental health centers and state hospitals。Hospital and Community Psychiatry,28(5),379-381。  new window
14.謝佳容、蕭淑貞(20060900)。臺灣社區精神復健機構的服務現況與展望。精神衛生護理雜誌,1(2),41-50。  延伸查詢new window
15.成和玲、楊美賞(19971200)。門診與社區復健精神分裂病患者生活品質之比較及影響生活品質之因素。高雄醫學科學雜誌,13(12),748-756。  延伸查詢new window
會議論文
1.李玫姿(2004)。精神疾患就診行為分析。臺北市:行政院衛生署。  延伸查詢new window
研究報告
1.王惠玄(2003)。社區復健中心成效及成本效益評估 (計畫編號:DOH92-TD-1029)。臺北市:衛生署。  延伸查詢new window
2.葉玲玲(2008)。慢性精神疾病患者社區復健需求面與供給面之探討研究 (計畫編號:DOH96-TD-M-113-045)。  延伸查詢new window
學位論文
1.吳希文(2011)。臺灣社區復健模式對精神分裂症病患醫療利用的影響(博士論文)。臺灣大學。  延伸查詢new window
2.吳欣燕(2004)。社區復健中心成效及成本效能分析(碩士論文)。長庚大學。  延伸查詢new window
3.林偕益(2004)。精神分裂症患者醫療資源使用之影響因子探討(碩士論文)。高雄醫學大學。  延伸查詢new window
4.林麗瑞(2006)。慢性精障者醫療資源利用相關性研究(碩士論文)。靜宜大學。  延伸查詢new window
5.曾洙荔(2003)。慢性精神病患社區復健成效探討(碩士論文)。慈濟大學。  延伸查詢new window
6.葉玲玲(2003)。台灣精神分裂症患者之健康照護需要與需求研究(博士論文)。國立陽明大學。  延伸查詢new window
7.陳巧珊(2009)。社區復健模式對精神分裂症患者再入院風險影響(碩士論文)。臺北醫學大學。  延伸查詢new window
圖書
1.鄭若瑟(2003)。臺灣精神障礙者照顧之現況分析與未來發展--醫療面。臺灣精神障礙者照顧發展研討會彙編。臺北市:財團法人國家衛生研究院論壇長期照護委員會。  延伸查詢new window
 
 
 
 
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