探討社經地位對血管支架置入病患死亡風險之影響__臺灣人文及社會科學引文索引資料庫

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題名：	探討社經地位對血管支架置入病患死亡風險之影響
書刊名：	臺灣公共衛生雜誌
作者：	黃鈞奕／陳慧珊／張嘉恬／吳肖琪
作者(外文)：	Huang, Chun-i／Chen, Hui-shan／Chang, Chia-tien／Wu, Shiao-chi
出版日期：	2015
卷期：	34:1
頁次：	頁37-49
主題關鍵詞：	社經地位；血管支架；塗藥支架；死亡；Socioeconomic status；Stents；Drug-eluting stents；Mortality
原始連結：	連回原系統網址
相關次數：	被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0) 排除自我引用:1 共同引用:0 點閱:11

目標：台灣全民健保大幅減少民眾就醫費用之負擔，改善民眾就醫可近性，在此情況下是否能消弭健康不平等？本研究針對接受治療冠心病的重要方法－血管支架置放術(stentimplantation)之患者，探討社經地位是否會影響其死亡情形。方法：本研究採回溯性世代研究法，使用2008-2010年全國健保及相關次級資料，以2009年第一次接受血管支架置入之成年病患(19,113位)為研究對象，以邏輯斯迴歸探討血管支架置入病患之社經地位(教育程度與收入狀況)對其一年內死亡情形之影響，並控制病人特質、共病症指數及醫院特質。結果：2009年接受血管支架置入新個案之一年內心血管疾病死亡率為5.65%、全死因死亡率為11.93%。校正相關變項後發現，教育程度為小學以下者之心血管疾病死亡及全死因死亡風險分別為大專以上者之1.37倍(95%CI=1.06-1.77)及1.54倍(95%CI=1.28-1.85)；而低收入者之心血管疾病死亡及全死因死亡風險分別為高收入者之1.22倍(95%CI=1.02-1.46)及1.16倍(95%CI=1.02-1.32)，教育程度之差距較收入差距大。結論：接受血管支架置入病患在死亡風險上存在社經差異，建議衛生主管單位可加強提升低社經族群的健康識能，以縮小不同社經地位之血管支架置入病患的健康差距。

以文找文

Objectives: The burden of medical expenditures has been reduced and the accessibility to health care has improved as a result of the implementation of the Taiwan National Health Insurance program. Nevertheless, does health inequality still exist? The objective of this study was to determine the association between the cross-level effects of individual socioeconomic status (SES) on mortality in patients who have undergone stent implantation in Taiwan. Methods: This study involved a retrospective cohort. Adults from the 2008-2010 Taiwan National Health Insurance database who underwent stent implantation in 2009 and relative secondary data were examined. Logistic regression models were performed to determine the effect of SES (educational level and income status) on the 1-year mortality rate by controlling the characteristics of patients and major health care organizations. Results: The 1-year mortality rate of patients who underwent stent implantation in 2009 was 11.93%. Patients with a primary school level of education had a 1.54-fold risk of death compared to patients with a university education after controlling for other factors (OR=1.54, 95% CI=1.28-1.85), and the risk of death in the low-income group was 1.16- fold that of the high-income group (OR=1.16, 95% CI=1.02-1.32). Conclusions: Disparities in mortality exist between different SES groups. If the government enhances healthy literacy in the low-SES group, the gap in health disparities for patients who undergo stent implantation might decline.

以文找文

期刊論文
1.	Marmot, M.(2005)。Social determinants of health inequalities。Lancet，365，1099-1104。
2.	Hsu, C. C.、Lee, C. H.、Wahlqvist, M. L.(2012)。Poverty increases type 2 diabetes incidence and inequality of care despite universal health coverage。Diabetes Care，35，2286-2292。
3.	Alter, D. A.、Iron, K.、Austin, P. C.、Naylor, C. D.(2004)。Socioeconomic Status, Service Patterns, and Perceptions of Care among Survivors of Acute Myocardial Infarction in Canada。JAMA，291，1100-1107。
4.	Jakobsen, L.、Niemann, T.、Thorsgaard, N.(2004)。Dimensions of socioeconomic status and clinical outcome after primary percutaneous coronary intervention。Circ Cardiovasc Interv，5，641-648。
5.	Shimony, A.、Zahger, D.、Ilia, R.、Shalev, A.、Cafri, C.(2010)。Impact of the community's socioeconomic status on characteristics and outcomes of patients undergoing percutaneous coronary intervention。Int J Cardiol，144，379-382。
6.	Mehta, R. H.、O' Shea, J. C.、Stebbins, A. L.(2011)。Association of mortality with years of education in patients with ST-segment elevation myocardial infarction treated with fibrinolysis。J Am Coll Cardiol，57，138-146。
7.	Stirbu, I.、Looman, C.、Nijhof, G. J.、Reulings, P. G.、Mackenbach, J. P.(2012)。Income inequalities in case death of ischaemic heart disease in the Netherlands: a national record-linked study。J Epidemiol Community Health，66，1159-1166。
8.	Hardarson, T.、Gardarsdottir, M.、Gudmundsson, K. T.、Thorgeirsson, G.、Sigvaldason, H.、Sigfusson, N.(2001)。The relationship between educational level and mortality。The Reykjavik Study. J Intern Med，249，495-502。
9.	Denvir, M. A.、Lee, A. J.、Rysdale, J.、Walker, A.、Eteiba, H.、Starkey, I. R.、Pell, J. P.(2006)。Influence of socioeconomic status on clinical outcomes and quality of life after percutaneous coronary intervention。Journal of Epidemiology & Community Health，60，1085-1088。
10.	洪尉欽(2008)。冠狀動脈心臟病及介入性治療。義大醫訊，4，26-30。延伸查詢
11.	Aggarwal, B.、Ellis, S. G.、Lincoff, A. M.(2013)。Cause of death within 30 days of percutaneous coronary intervention in an era of mandatory outcome reporting。J Am Coll Cardiol，62，409-15。
12.	Shishehbor, M. H.、Goel, S. S.、Kapadia, S. R.(2008)。Longterm impact of drug-eluting stents versus bare-metal stents on all-cause mortality。J Am Coll Cardiol，52，1041-8。
13.	Pandya, S. B.、Kim, Y. H.、Meyers, S. N.(2010)。Drug-eluting versus bare-metal stents in unprotected left main coronary artery stenosis a meta-analysis。JACC Cardiovasc Interv，3，602-11。
14.	Epstein, A. J.、Polsky, D.、Yang, F.、Yang, L.、Groeneveld, P. W.(2011)。Coronary revascularization trends in the United States 2001-2008。JAMA，305，1769-76。
15.	Puymirat, E.、Mangiacapra, F.、Peace, A.(2013)。Safety and effectiveness of drug-eluting stents versus baremetal stents in elderly patients with small coronary vessel disease。Arch Cardiovasc Dis，106，554-61。
16.	黃雪娥、陳科呈、殷偉賢、蔡維河、葉明陽(20100800)。塗藥心臟血管支架之醫療費用結構與成本效益分析--與傳統支架之比較。內科學誌，21(4)，258-269。延伸查詢
17.	Mieres, J.、Fernandez-Pereira, C.、Risau, G.(2012)。One Year outcome of patients with diabetes mellitus after percutaneous coronary intervention with three different revascularization strategies: results from the Diabetic Argentina Registry (DEAR)。Cardiovasc Revasc Med，13，265-271。
18.	Loh, J. P.、Pendyala, L. K.、Kitabata, H.(2013)。A propensity score matched analysis to determine if secondgeneration drug-eluting stents outperform firstgeneration drug-eluting stents in a complex patient population。Int J Cardiol，170，43-48。
19.	Kalesan, B.、Pilgrim, T.、Heinimann, K.(2012)。Comparison of drug-eluting stents with bare metal stents in patients with ST-segment elevation myocardial infarction。Eur Heart J，33，977-987。
20.	Salomaa, V.、Niemela, M.、Miettinen, H.(2000)。Relationship of socioeconomic status to the incidence and prehospital, 28-day, and 1-year mortality rates of acute coronary events in the FINMONICA myocardial infarction register study。Circulation，101，1913-1918。
21.	Alter, D. A.、Franklin, B.、Ko, D. T.(2013)。Socioeconomic status, functional recovery, and long-term mortality among patients surviving acute myocardial infarction。PLoS One，8，e65130。
22.	Sandgren, T.、Sonesson, B.、Ahlgren, R.、Lanne, T.(1999)。The diameter of the common femoral artery in healthy human: influence of sex, age, and body size。J Vasc Surg，29，503-510。
23.	Mikhail, G. W.(2006)。Coronary revascularisation in women。Heart，92 (Suppl 3)，19-23。
24.	Loboz-Grudzien, K.、Jaroch, J.(2011)。Women with acute coronary syndromes have a worse prognosis - why? The need to reduce 'treatment-seeking delay'。Cardiol J.，18，219-221。
25.	Argulian, E.、Patel, A. D.、Abramson, J. L.(2006)。Gender differences in short-term cardiovascular outcomes after percutaneous coronary interventions。Am J Cardiol，98，48-53。
26.	Ndrepepa, G.、Schulz, S.、Neumann, F. J.(2013)。Bleeding after percutaneous coronary intervention in women and men matched for age, body mass index, and type of antithrombotic therapy。Am Heart J，166，534-540。
27.	Akhter, N.、Milford-Beland, S.、Roe, M. T.、Piana, R. N.、Kao, J.、Shroff, A.(2009)。Gender differences among patients with acute coronary syndromes undergoing percutaneous coronary intervention in the American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR)。Am Heart J.，157，141-148。
28.	Suessenbacher, A.、Doerler, J.、Alber, H.(2008)。Gender-related outcome following percutaneous coronary intervention for ST-elevation myocardial infarction: data from the Austrian acute PCI registry。EuroIntervention，4，271-276。
29.	Hoebers, L. P.、Claessen, B. E.、Dangas, G. D.(2013)。Longterm clinical outcomes after percutaneous coronary intervention for chronic total occlusions in elderly patients (≥ 75 years): five-year outcomes from a 1,791 patient multi-national registry。Catheter Cardiovasc Interv，82，85-92。
30.	Lee, M. G.、Jeong, M. H.、Lee, K. H.(2012)。Prognostic impact of diabetes mellitus and hypertension for mid-term outcome of patients with acute myocardial infarction who underwent percutaneous coronary intervention。J Cardiol，60，257-63。
31.	Wang, J. Y.、Wang, C. Y.、Juang, S. Y.(2014)。Low socioeconomic status increases short-term mortality of acute myocardial infarction despite universal health coverage。Int J Cardiol，172，82-87。
32.	Khattab, A. A.、Hamm, C. W.、Senges, J.(2009)。Sirolimuseluting stent treatment at high-volume centers confers lower mortality at 6-month follow-up: results from the prospective multicenter German Cypher Registry。Circulation，120，600-606。
33.	Shavers, V. L.(2007)。Measurement of socioeconomic status in health disparities research。J Natl Med Assoc，99(9)，1013-1023。
34.	McMurray, J. J.、Ostergren, J.、Swedberg, K.(2003)。Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial。Lancet，362，761-771。
35.	Sanchis, J.、Nunez, J.、Bodi, V.(2011)。Influence of comorbid conditions on one-year outcomes in non-ST-segment elevation acute coronary syndrome。Mayo Clin Proc，86，291-296。
36.	Romano, P. S.、Roos, L. L.、Jollis, J. G.(1993)。Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: differing perspectives。J. Clin. Epidemiol.，46，1075-1079。

會議論文
1.	Parng, I. M.、Chen, L. S.、Lee, C. H.、Chou, Y. J.(2008)。Impact of drug-eluting stents balance billing on recipients and treatment outcome。San Diego, CA：APHA。

研究報告
1.	行政院衛生福利部統計處。死因統計。延伸查詢

學位論文
1.	葉憲宗(2010)。第二型糖尿病人施行塗藥血管支架手術後服用Thiazolidinediones對其預後之影響(碩士論文)。國立陽明大學，臺北。延伸查詢
2.	郭淑惠(2008)。塗藥型血管支架納入健保部份給付之成效評估(碩士論文)。高雄醫學大學。延伸查詢
3.	侯美夙(2008)。全國施行冠狀動脈繞道術及冠狀動脈介入性治療之醫療品質與資源利用探討(碩士論文)。高雄醫學大學。延伸查詢
4.	李佳俞(2009)。民眾對塗藥支架差額負擔的接受度--以台中某區域級教學醫院為例(碩士論文)。亞洲大學。延伸查詢
5.	陳姿菁(2014)。接受塗藥心臟血管支架(DES)與傳統心臟血管支架(BMS)之病患其臨床結果及健保醫療資源利用分析(碩士論文)。國立陽明大學。延伸查詢
6.	蘇美如(2012)。探討合併慢性腎臟病與使用塗藥支架對血管支架置入病人預後情形之影響(碩士論文)。國立陽明大學。延伸查詢
7.	張煜詩(2013)。探討個人與區域社經地位對術後品質之影響-以冠狀動脈繞道手術病患為例(碩士論文)。國立陽明大學。延伸查詢

其他
1.	劉世奇(2013)。醫師說：「血管慢性阻塞太久，心導管很難打...」，我該怎麼辦？，http://www.skh.org.tw/download/血管慢性阻塞太久,%20心導管很難打通該怎麼辦.pdf， 2013/09/05。延伸查詢
2.	台灣大學附設醫學院雲林分院心導管室(2013)。健保部份給付塗藥/塗層血管支架品項表，http://www.ylh.ntuh.gov.tw/upload/data/medicine_manage_training/2013_09_3_455257.pdf。延伸查詢

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