| Summary: | 碩士 === 長庚大學 === 醫務管理學研究所 === 97 === Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders in child and adolescents. According to the study results of Dr. Susan S.F. Gau, Taiwan ADHD prevalence rates in seventh, eighth and ninth grades are 7.5%, 6.1% and 3.3%, respectively. ADHD not only affects the school performance and social relationship of the patients, but also creates burdens on families and the society. As stated in literatures, learning ability, social and family relationships of ADHD children can improve significantly, if their ADHD can be diagnosed and treated early. Furthermore, those children can have good achievements in the future.
The study consists of database analysis of the ADD or ADHD outpatient records of the Bureau National Research Institute from 2004-2006, provided by National Data Consultant and the questionnaires of child and adolescent psychiatrists (CAPs). The objectives of the study can be summarized into three aspects: (1) To analyze the changes on the number of ADHD outpatient visits and the distribution differences among all BHNI offices, the level of hospital accreditation and hospital ownership. (2) To find out the usage of short-acting/long-acting stimulants and their average daily dosages. (3) To understand the current outpatient services provided by CAPs with questionnaires.
The analysis showed that: (1) Numbers of the outpatient visits has increased 2.2 times from 15,320 visits in Q1, 2004 to 33,000 visits in Q4, 2006. It indicates that the need of ADHD outpatient medical demand has increased quarter by quarter. (2) The average daily dosage of Ritalin (short-acting) and Concerta (long-acting) are between 12.0~14.4 mg/day and 15.6~19.9 mg/day, respectively. As to the usage of short and long-acting drugs, in Q4 of 2004, 86% and 14% of cases prescribed with Ritalin and Concerta, respectively. In Q4 of 2006, the percentage between the two medications changed to 60% and 40%, respectively. The percentage of cases taking Concerta has increased year by year. (3) According to survey results, the CAPs have average 2.7 outpatient sections per week and 21.7 cases per section. The average time required for each visit of first and subsequent visit are 36.7 and 13.9 minutes, respectively. 61.2% of doctors expressed that the family members found it difficult to make an outpatient appointment by them. Based on the level of hospital accreditation, 50% of CAPs who were employed by medical centers. Therefore, half of ADHD cases are treated in the medical centers. Based on the distribution of BNHI offices, there are only five CAPs located in the Eastern BNHI branch office. It is a relatively poor region on medical resources.
In summary, ADHD affects quite a number of cases and families. The health authority should provide matching medical resources, appropriate insurance reimbursement guideline, and long-term behavior/medication treatment plans in order not only to reduce the burdens on families, schools and the society, but also to help more ADHD children enjoy learning normally and growing up happily.
|
|---|
