| Summary: | 碩士 === 慈濟大學 === 公共衛生學系碩士班 === 102 === Influenza is a common disease, and it results in substantial impact on morbidity, mortality and increases burden on medical utilization around the world. A paper showed that in 1999 and 2000, Taiwanese spent NT$24.1 billion (14.23%) and NT$24.9 billion (14.30%) of total National Health Insurance outpatient expenses on outpatient care for colds and influenza. Medical expenditures of Influenza account for a certain proportion of total expenditures of National Health Insurance. Some studies also indicated that young children were at high risk for influenza. The study’s objective was to analyze health service utilization among young people under 18 years old with influenza by using the 40,000 samples from the Taiwan National Health Insurance database. This was a retrospective study and based on the data of influenza patients in 2003, 2006, and 2009. We selected patients with ICD-9-CM codes from 480-487 as study subjects and use the software of SAS to analyze the medical expenditure and medical utilization.
A total of 2449 visits (1035 persons) were found in ambulatory care in 2003, 2585 visits (1153 persons) in 2006, and 4051 visits (1700 persons) in 2009; A total of 100 visits (93 persons) in emergency in 2003, 98 visits (89 persons) in 2006, 317 visits (290 persons) in 2009 were identified in the final analysis; A total length of day was 627 days(122 persons) in hospitalization in 2003, 603 days (134 persons) in 2006, and 744 days (138 persons) in 2009.
Univariate logistic regression showed that the probability of spending higher medical expense on ambulatory care in 2003 was related to age, sex , chronic disease, season, urbanization levels, the department of visiting, hospital ownership; In 2006, the probability of spending higher medical expense on ambulatatory care was related to age, catastrophic illness, chronic disease, season, urbanization levels, the department of visiting, hospital ownership ; In 2009, the probability of spending higher medical expense on ambulatatory care was related to age, chronic disease, season, urbanization levels, the department of visiting, hospital ownership. In 2003, the probability of spending higher medical expense on emergency care was related to season, the department of visiting. In 2006, the probability of spending higher medical expense on emergency care was related to age, urbanization levels. In 2009, The probability of spending higher medical expense on emergency care was related to age, season, hospital ownership. In 2003 and 2009, the probability of spending higher medical expense on inpatient care was related to age.
The visits of outpatients were significantly related to age, chronic disease, season, department of visits in 2003, and were related to age, chronic disease, urbanization levels, the department of visiting in 2006 , and were related to age, chronic disease, season, department of visits, hospital ownership in 2009. The visits of emergency were related to catastrophic illness in 2003 and 2006, and was related to age in 2009. The days of hospitalization were just related to age in 2003.
This research is the first to evaluate medical utilizations among young people with influenza based on the national health insurance research database in Taiwan. This study can provide information to the researchers who want to research about children with influenza.
|
|---|
