| Summary: | 碩士 === 中臺科技大學 === 健康產業管理研究所 === 100 === Background: Domestic research of medical utilization for chronic respiratory diseases mainly focuses on obstructive pulmonary disease, asthma, and respiratory care. Utilization and cost of medical services for bronchiectasis-associated diseases is an issue seldom discussed in previous research. Based on National Health Insurance Research Database, this study attempted to explore the development of bronchiectasis-associated diseases in Taiwan, utilization and cost of bronchiectasis-associated hospitalization, and factors affecting medical utilization.
Methods: From National Health Insurance Research Database maintained by National Health Research Institute, this study extracted hospitalization data of patients diagnosed with bronchiectasis (principal and secondary diagnosis by ICD-9-CM code of 494) during 1998~2008. Using patient characteristic, hospital characteristic, and hospital location as independent variables and cost of hospitalization as a dependent variable, this study conducted univariate analysis, bivariate analysis, and multivariate analysis of the data respectively.
Results: Results indicated that a total of 97,912 persons utilized hospitalization services for bronchiectasis-associated diseases during 1998~2008. The hospitalization rate per 100,000 population was 39.5, and the rate was higher among women than among men. Patients aged above 65 had a higher frequency of hospitalization for bronchiectasis. The average length of hospital stay was 11.13 days, and the average cost of hospitalization was NT$47,797.01. Factors affecting hospitalization for bronchiectasis included gender, age, reported salary of the insured, Charlson Comorbidity Index (CCI) score, length of hospital stay, hospital accreditation status, hospital ownership status, and administrative branch of Bureau of National Health Insurance. Conclusions and Suggestions: It should be noted that the prevalence of bronchiectasis was significantly higher among women and people with lower socio-economic status. Therefore, more health education and preventive measures should be provided to these groups of people to reduce incidence of bronchiectasis and medical expenses required. Besides, frequency of hospitalization for bronchiectasis also increased with age. As the ratio of elderly population is on the increase in Taiwan, more emphasis should be placed on preventive care for the elderly.
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