| Summary: | 碩士 === 中山醫學大學 === 醫療產業科技管理學系碩士班 === 100 === Low back pain is a very common health problem among health professionals, which is also a very important national health issue. Although research have found that health professionals are among the high risk group for low back pain, very few of them focus on the difference of the medical behavior and medication pattern used between general population and health care professionals. Our research intent to analyze the difference of the medical behavior and medication pattern used between female nursing staff, other female health care professionals, and general female population through National Health Insurance database. The source of the data came from claims data of the sampled registry of beneficiaries of National Health Insurance from 2005 to 2009. ICD-9-CM with initial three codes as 720, 721, 722 or 724 were selected with the exclusion of the codes that indicate illness located at the cervix or thorax regions. All those receiving treatments continued for more than 90 days or recurred during the survey were also excluded. After combining the data with basic profile of the health care professionals, a total of 1566 female nursing staffs; 391 female health care professionals other than nurses and 82728 general female patients with acute low back pain were collected for the study.
Research findings: The difference between the three study groups were significant in the aspects of the region of ambulatory care, the level of hospital and the specialty that they attend for their first visit under the diagnosis of acute low back pain. Only 18.8% of the general female population visited hospitals leveled above Regional hospitals in compare with more than 30% within female nursing staffs and other health professionals (P<0.001). The biggest difference among the choice of specialty was in Rehabilitation Medicine, while 13.35% of the female nursing staff and 17.65% of the other female health care professionals attend as their first ambulatory visit, only 7.6% of the general female population chose Rehabilitation Medicine as their first ambulatory visit specialty(P<0.0001). To compare the treatment received, 22.03% of the female nursing staff; 20.72% of the other professionals received medication treatment while general female population had a higher percentage of 28.51%, which is statistically significant, (P<.0001). 15.94% of the female nursing staff received rehabilitation treatment, while 17.62% of the other female health care professionals and only 11.71% of the general female population also received rehabilitation treatment (P<.0001). The ratios were opposite for the percentage receiving Chinese medicine, when 12.15% of the general population received Chinese medicine, only 9% and 8.18% of the female nursing staff and other health care professionals received Chinese medicine (P<.0001). When it comes to medication pattern, our research divided the medication used into single drug and combination drug treatment. The percentages of the use of single drug treatment among female nursing staff, female health care professionals and general female population were 73.91%、81.48% and 74.88%, while the percentages of the use of combination drug treatment among female nursing staff, female health care professionals and general female population were 26.09%, 18.52% and 25.12%. There were no statistical significant for the use of single/combination drug treatment among these three groups (P =0.3591). The multivariate analysis showed that the year of claims, age, salary for insurance, the region of claims, the hospital level for first ambulatory visit, and the specialty for first ambulatory visit for acute low back pain were the factors that influenced the medication pattern of single/combination drug treatment.
Conclusions: The medical behavior for acute low backpain was different between female nursing staff, other health professionals and the general population. Female health care professionals including nurses tend to visit hospital leveled above the Regional hospital and the Rehabilitation Medicine ambulatory clinic for help in the beginning, and also received more rehabilitation treatment when compared with general population. The female general population who had acute low back pain, on the other hand, tends to visit primary care clinic first and received more Chinese Medicine treatment. The medication pattern was not different between the three groups. The factor influencing the pattern of medication prescribed includes the year of claims, age, salary for insurance and the region of claims, the hospital level for first ambulatory visit, and the specialty for first ambulatory visit for acute low back pain. Further research is needed to understand the nature and cause of acute low back pain in medical professionals in order to establish preventive policies.
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