Comparisons of Inpatient Mortality of Pneumonia Patients between Military and Non-military Hospitals

• Main Authors: Chun-Hsien Chu, 朱峻賢
• Other Authors: Kuo-Cherh Huang
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/32196269763436725124

碩士 === 臺北醫學大學 === 醫務管理學研究所 === 98 === Military health care encompasses a diverse range of programs and has been included into the National Health Insurance program since March 1, 2001. The phenomenon results in an increasing number of patients in military hospitals shifting to non-military hospitals, mostly because of poor impressions of patients regarding military hospital services. However, research on the differences of medical care quality between military and non-military hospitals is still lacking. Although patients could check quality of medical care of the six specific diseases (including diabetes) through the National Health Insurance Bureau website, there is short of information of medical care outcome of military hospitals. Utilizing the National Health Insurance Research Database of the study, the purpose of the study is aimed to compare inpatient mortality of pneumonia patients between military and non-military hospitals. For the study, the hospitals were classified as military hospitals, public non-military hospitals, private hospitals and for-profit hospitals. And control variables were patient characteristics (such as age and gender), clinical characteristics (such as the comorbidity index and use of ventilator) and care provider characteristics (such as hospital level, hospital location, service volumes of hospital physicians and clinical specialty). Results indicated medical care quality for pneumonia patients of military hospital was better than that of non-military public hospitals, with no significant difference to private hospitals, but was relatively poor compared with that of for-profit hospitals. And, patient characteristics, clinical characteristics, characteristics of care providers all exerted significant influences on medical outcome of pneumonia patients. Efficacy of health care provided by military hospitals has reached a rather good level currently. Therefore, if the general public or military soldiers are encouraged to choose military hospitals if it is more convenient for them when health care needs occur. Regarding the treatment of pneumonia patients, hospitals, patients themselves and their family members should pay particular attention to patients, and use aggressive treatment and health management approach for better medical care outcome. The limitation of the study is that secondary data source was used, and therefore many confounding variables (such as healthcare utilization) could not be taken into account. It is recommended that in the future researchers should investigate the topic of quality of life and other related issue. Finally, it is recommended that (1) health authorities should establish a database of patients with highly infectious diseases to facilitate long-term tracking of those patients. (2) Local and area hospitals are responsible for pneumonia. (3) Preventive policy should be made to those with high risk of death. Such information could not only be used for future research, but also for disease management.