| Summary: | 碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 100 === Background and objectives: Parkinson’s disease (PD) is a chronic progressive neurodegenerative disorder, which mostly appears in elderlies. As an important disease for old people, PD’s prevalence rate is slightly lower than that of Alzheimer’s disease. In the early stage of PD, the symptoms are not obvious. Until now, there is no physiology criteria used in PD diagnosis. Therefore, patient will seek for medical explanations by visiting multiple hospitals or clinics as PD’s symptom emerges. The aim of this study was to examine the medical utilization of the PD patients before and after they were diagnosed , and compare it with those who did not have PD to find out the impacts that PD on patients’ medical seeking behavior.
Methods: The data are selected from National Health Insurance Research Database from 2007 to 2009. As a case-control design is used, we have 2 groups of study targets. A total 222 patients diagnosed with PD (ICD-9 code 332.0), treated with PD medications in 2008 and without any PD diagnosis in 2007 are the case group. Other 444 patients who were randomly match by sex, age and “level of the most frequently visited institution” serves as control group. The medical care utilization by the case group within 1 year before and after diagnosis is explored and compared to that of the control group. The study used paired-sample t test, independent two sample t test and General Estimation Equation (GEE) to test the hypotheses.
Results: The ambulatory expenditure (total fees, drug fees) of PD patients after diagnosis was significantly higher than they did before diagnosis, while the number of ambulatory visits did not have significant change. PD patients used significantly more ambulatory services (total clinics visits, total fee) than control group before and after diagnosis. The diagnosis has no significant effect on hospitalization care.
Conclusions: PD patients used significantly more ambulatory services than control group before and after diagnosis. The diagnosis increases the medical need of PD patients.
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