低體重早產兒的住院醫療資源耗用分析

Analysis of Hospitalized Care Resource Utilization of Low Birth Eight Premature Infants

10.6288/TJPH2002-21-06-02

翁新惠(Shine-Huey Wung)；楊長興(Chiang-Hsing Yang)

早產兒 ； 低體重兒 ； 醫療資源耗用 ； premature infant ； low birth weight ； resource utilization

台灣公共衛生雜誌

21卷6期（2002 / 12 / 01）

397 - 402

繁體中文

目標：本研究旨在分析低體重早產兒的首次住院醫療資源耗用狀況，並探討影響醫療資源耗用的相關因素。方法：以北部某醫學中心於民國87年89年之間338名低體重早產兒的住院及費用資料，進行回溯性研究。採用百分比以及複迴歸模式進行分析。結果：(1)出生體重小於750公克組的低體重早產兒之平均住院費用及平均住院天數，約是出生體重750-999公克組的兩倍，隨著出生體重的增加，住院醫療費用呈等比級數的下降。(2)出生體重、合併症數量及住院疾病嚴重度為影響低體重早產兒首次住院醫療資源之重要因素。影響住院日數及住院醫療費用之模式解釋量(R2)分別為0.70、0.69。結論：(1)出生體重750公克之早產兒為照護資源耗用的閾值點。(2)存活狀況不同對於資源耗用會有很大差異。(3)醫療給付應參考出生體重、疾病嚴重度、合併症之病例組合，並制定出院條件規範。

Objective: This study was to determine the resources that were used by initial hospitalized care for infants with low birth weight, and to explore the factors that contributed to the resource utilization. Methods: A retrospective study was designed to collect data from a medical center in northern Taiwan. From 1998 to 2000, all infants in the study were under 37 weeks gestation and weighed less than 2,500g at birth. Variables were examined using multiple regression for their independent effects on hospitalization resources. Results: (1) The average hospitalization resource utilization per surviving infant was twice as high for infants weighing under 750g as for the group of infants weighing between 750-999g. The cost dropped by gradient with birth weight in surviving infants. (2)Birth weight, number of complications and severity of illness were related to initial length of stay (R2: 0.70) in the hospital and hospital expenses (R2: 0.69). Conclusion: (1) Birth weight less than 750g was a critical point for resource utilization. (2) Initial hospital care resource utilization among surviving infants and non-survivors was significantly different. (3) Reimbursement for in patient care of low birth weight infants should be based on factors such as birth weight, number of complications, and severity of illness.

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