| Summary: | 碩士 === 輔仁大學 === 統計資訊學系應用統計碩士在職專班 === 104 === The objective of this study was to investigate the number, causes, medical resource consumption, and re-amputation risk factors of domestic amputations. Health insurance data from 2001 to 2010 were retrospectively analyzed using descriptive statistics, binary logistic regression, survival analysis, and time series analysis. A total of 2,167 amputations were recorded in 2007, with a higher incidence in men than in women. The patients' average age was 66.13 years, and the most common causes of amputation were diabetes, infection, and circulatory system diseases. Hospitalization cost and duration, both measures of medical resource consumption for the year, differed significantly depending on the cause of amputation, and the level and location of the hospital. The total number of amputation cases showed significant difference only with respect to the cause of amputation. Among the different causes of amputation, limb abnormality incurred highest hospitalization costs, patients with renal diseases had the longest hospitalization duration, while patients with diabetes had the highest number of amputations. Medical resource consumption showed a significant downward trend 3 years after amputation. Amputation patients with renal disease, a long hospitalization duration, and amputations performed at medical centers or regional hospitals, all consumed more medical resources than the estimated average. Diabetes and circulatory system diseases were risk factors of re-amputation, and these risks were 1.008 times, and 1.124 times that of infection related risk, respectively. The re-amputation risk for patients who underwent amputation at medical centers and regional hospitals were 1.666 times and 1.477 times that of amputations carried out at district hospitals, respectively. The model established to estimate future amputation number, and amputation-related medical costs based on a time series analysis, showed good predictive power. Medical resources consumed by amputation patients are enormous, and not only a burden to the patients, but also to their families, and to the entire society. Therefore, the government should pay greater attention to the continuous care, and physical and mental well-being of amputation patients, and effectively utilize and allocate medical resources.
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