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題名:台灣老年榮民背痛的醫療利用研究
作者:王馥庭
作者(外文):Fu-Ting Wang
校院名稱:元智大學
系所名稱:管理學院博士班
指導教授:李弘暉
學位類別:博士
出版日期:2015
主題關鍵詞:老年人榮民背痛醫療利用潛在類別分析Elderlyveteransback painutilizationlatent class analysis
原始連結:連回原系統網址new window
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背痛是老年人最常見的問題,也是造成高就診次的原因之一,本研究主要探討台灣老年榮民背痛的醫療利用,找出影響醫療利用的預測因子及潛在類別特徵,以提供衛生主管機關在制定相關醫療照護及就醫輔導政策上的參考。研究資料來源係使用國軍退除役官兵輔導委員會之2014年高就診榮民就醫資料,樣本數計3,301位老年榮民,並透過多元回歸分析及潛在類別分析(Latent Class Analysis, LCA)進行研究。發現教育程度較高者、居住於台北或高屏地區、有連續高就診紀錄、次診斷數愈多、領有身心障礙手冊、籍貫為台籍者,是影響醫療利用較高的預測因子。在榮民背痛醫療利用上,籍貫為台籍、次診斷數越多者,成為「高度利用組」的比較高;教育程度屬於大專以上、居住於高屏地區、有連續高就診紀錄及次診斷數越多者,成為「相對高利用組」的機率比較高。經由本研究結果,發現影響醫療利用的預測因子,另透過LCA的方法將老年榮民背痛醫療利用區隔出三種不同的潛在類別(高度利用、規律利用及相對高利用組),逐一將各潛在類別特徵予以釐清,期使專業醫療及相關人員能更有效地執行就醫輔導工作,以改善病患的就醫行為,使有限的醫療資源得以妥善運用。
The purpose of this study was to investigate the common causes of back pain in the medical facilities of Taiwan using healthcare system database. In particular, the focus was on elderly veterans and its utilization of medical resources in a way to offer insights for healthcare relevant implications. The database of Veterans Affairs Council (VAC) was used to identify subjects in this study. A number of criteria were set to generate 3,301 elderly veterans who were, aged above 65, suffering with back pain. Multiple regression analysis and latent class analysis (Latent Class Analysis, LCA) were applied for data analysis. The results indicated that several factors were correlated with elderly veterans suffered with back pain pertaining to utilizing medical services. The factors with promoting effect include higher education level, resident in Taipei or Kaohsiung and Pingtung areas, higher frequency of medical visits, diagnosis with more comorbidity/complication (CC), licensed with disabled card and a native of Taiwan. In specific, those factors were further differentiated into three categories (high potential group, regular potential group and relative high potential group). Veterans who are a native of Taiwan and diagnosis with more(C/C) presented as the high potential group of utilizing medical resources. Based on the results, a model to identify the factors affecting medical utilization for back pain was validated using the database and groups with high probabilities to approach medical services were identified. The healthcare implication of this study indicates that the importance of targeting this high potential group to facilitate interventions to promote the effectiveness of medical utilization for veterans.
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