Investigation of associations and medical resource utilization between glaucoma with dementia

• Main Authors: chun-hsien Liu, 劉俊賢
• Other Authors: Hon-Yi Shi
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/67995795880007041225

碩士 === 高雄醫學大學 === 醫務管理暨醫療資訊學系碩士在職專班 === 104 === Research Purpose Glaucoma is a degenerative disease of the optic nerve, which pathologic changes with dementia are very similar. Glaucoma and dementia medical demands increase in Taiwan, but still lack current trend and medical resource utilization analysis of dementia in patients with glaucoma and. Thus, our study purposed to explore the trend of dementia in patients with glaucoma in Taiwan and to analyze the medical resource utilization and related predicting factors. Research Method This retrospective study using National Health Insurance Research Database from 1998 to 2012, primary/ secondary diagnosis of glaucoma with a total of 15,762 patients was enrolled, and the occurrence of dementia after glaucoma diagnosis enrolled 431 patients. The data are collected and conducted the descriptive statistical analysis, independent T test, multiple regression analysis and Cox proportional hazards analysis. Research Result A total of 15,762 glaucoma patients showed　431 cases of dementia occurred later (2.73%) ,　which 240 cases was females (55.7%). The trend of glaucoma with dementia patient in CCI, the average LOS, the average hospital charges of outpatient and average hospital charges of inpatient care are increased. To compare 2 subtype of glaucoma with dementia showed open-angle glaucoma in the LOS(2.4 ± 0.89 days vs. 6.53 ± 7.06 days, P = 0.015) and total outpatient medical expenses (NT1077.18 ± 608.40 vs. NT1611.79 ± 1912.42, P <0.001) significantly lower than angle-closure glaucoma, but in the number of outpatient visit and total inpatient medical expenses have no significant differences. In view of the relative risk (RR), the relative risk of glaucoma occurred dementia was 2.68, open angle glaucoma 2.22, and the angle-closure glaucoma 3.22. Conclusion and Suggestion Age is most important related factor of glaucoma patients with dementia, and little impact for glaucoma classification. In view of medical resource utilization, medical resources utilization in glaucoma patients with dementia is increasing trend. The main influencing factors are age, high degree of urbanization, underwent surgery and CCI.