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題名：臺灣地區智能障礙老人門診利用情形初探
書刊名：臺灣老人保健學刊
作者：徐尚為 引用關係／江博煌／陳昭芸／陳思瑾
作者(外文)：Hsu, Shang-wei／Chiang, Po-huang／Chen, Zhao-yun／Chen, Si-jin
出版日期：2011
卷期：7:2
頁次：頁94-110
主題關鍵詞：智能障礙；智能障礙老年人；醫療利用；Elderly with intellectual disabilities；Ambulatory；Healthcare utilization
原始連結：連回原系統網址new window
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目的：智能障礙者常合併其他障礙，因此對醫療的需求高於一般人口群，然而我國對於他們實際醫療利用之相關研究卻相當缺乏。因此本研究希望藉由分析健保資料庫來瞭解智能障礙老年人的醫療利用情形，以及年齡別、投保區都市化程度、智障程度與部分負擔情形等變項與醫療利用情形之相關性。方法：申請2007年年齡大於等於65歲之智能障礙者全民健康保險資料，以統計軟體SAS9.2版進行串檔後歸人，並依照國際疾病分類（ICD-9-CM）區分為輕度、中度、重度、極重度與臨界智能障礙等五類分別探討就醫差異與相關性。結果：研究樣本共2463人，其中男性1167人，平均73.6±7.0歲；女性1296人，平均73.2±7.2歲。研究樣本平均一年門診次數為35.5±27.8次，75-79歲年齡層之就醫次數，高於其它年齡層；輕度智障老年人之平均門診次數顯著高於中、重度者；其他因素則不影響門診利用。智障等級不同，每次門診費用與累積年門診費用顯著不同；重大傷病者每次門診費用與累積年門診費用顯著高於其它樣本。結論：全民健保實施，增加了弱勢族群醫療服務的可用性與可近性，也證明智能障礙族群之醫療需求高於一般人。如何針對智障老人提供衛生教育及預防醫學服務，降低慢性病盛行率，以減少健保支出是重要課題。
To analyze and describe the patterns of ambulatory care utilization by the intellectual disability older people. Methods: The 2007 National Health Insurance ambulatory care expenditures by visits records of intellectual disability older people were used to explore the usage of medical resources. Results: The average ambulatory visit number of sample was 35.5±27.8 times per year, which was much higher general elderly. The average medical expense per visit was 1191.6±3566.9 dollars and 42334.2±73558.4 dollars annually. The three most frequent principal diagnoses of elderly ambulatory visits were diseases of the circulatory system, diseases of the respiratory system, diseases of the nervous system and sense organs, and diseases of the musculoskeletal system and connective tissue. Conclusion: The mean frequency of ambulatory visits of the intellectual disability older people in Taiwan was higher than that of general population. How to provide health education and preventive services to intellectual disability elderly is an important issue, in terms of reduction the HNI expanse.
期刊論文
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學位論文
1.李佩娜(1997)。智障者利用醫療照護情形及其影響因素(碩士論文)。國防醫學院。  延伸查詢new window
2.李志偉(2002)。智能障礙者醫療照護需求評估-以台閩地區智能障礙者的醫療利用情形為例(碩士論文)。國防醫學院，臺北市。  延伸查詢new window
3.Kennedy, C.(2002)。Screening for Helicobacter pylori in adults with developmental disabilities-Prevalence of infection and testing considerations for urea breath test, serology and whole-blood methods，Kingston, Ontario, Canada。  new window
圖書
1.內政部統計處(2007)。95 年身心障礙者生活需求調查。台北市。  延伸查詢new window
其他
1.內政部統計處(2011)。內政統計年報，http://sowf.moi.gov.tw/stat/year/list.htm， 20111110。  延伸查詢new window
2.中央健康保險局(2011)。台灣健保改革與未來政策發展方向，http://www.nhi.gov.tw/Resource/webdata/19274_1_全民健保改革與未來政策發展方向.pdf， 20111110。  延伸查詢new window
 
 
 
 
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