| Summary: | 碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 97 === The management of Bureau of National Health Insurance has encountered a hard situation in the recent years. The policy of treatment for common disease tends to be more conservative in each hospital in order to control the cost of medical resources. The ultrasound has played a role in diagnosis the location for uterine myoma and helps us to decide the method of myomectomy. So far the application of laparoscopic technology has improved the treatment of uterine myomas. However, its clinical efficacy is still unknown. The aim of this study is to compare the medical cost and clinical outcomes between these methods of myomectomy.
Methods：From June 2004 to October 2007, we studied 155 patients who under went myomectomy. We analyzed the difference of cost and clinical outcome in women undergoing abdominal myomectomy (AM) (n=74) and laparoscopic myomectomy (LM) (n=81) for symptomatic fibroid in a teaching hospital.
Results：The results indicate that the patients underwent laparoscopic myomectomy had fewer blood loss, compared to the patients underwent abdominal myomectomy. Also, after the surgery, patient underwent laparoscopic myomectomy''s WBC didn''t appear to have Inflammation. In addition, Platelet did not appear to be low and hct appeared to be higher than the patients of abdominal myomectomy. Regarding the medical cost, patients of laparoscopic myomectomy had higher cost than the patients of abdominal myomectomy. Because of the paying systme in Bureau of National Health Insurance, some fees of detailed item for patients of laparoscopic myomectomy were fewer than patietns of abdominal myomectomy. However, the satisfaction of patients of laparoscopic myomectomy appeared to be higher. And their quality of life appeared to be higher than those of patient underwent abdominal myomectomy.
Conclusion：It is evident that a large proportion of the budget of National Health Bureau will be spent in the advanced technology in the future. Facing this tendency, the government should start planning a new strategy in order to prevent social disorder due to the growth of advanced technology which will compromise the basic medical need of the general population.
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