台灣精神分裂症患者精神醫療利用與費用之分析探討

The Utilization and Expenditure of Psychiatric Services for Patients with Schizophrenia in Taiwan

10.6288/TJPH2003-22-03-05

葉玲玲(Ling-Ling Yeh)；藍忠孚(Chung-Fu Lan)；鄭若瑟(Joseph Jror-Serk Cheng)

精神分裂症 ； 精神醫療利用 ； 全民健保 ； 申報資料 ； schizophrenia ； utilization ； national health insurance ； claim data

台灣公共衛生雜誌

22卷3期（2003 / 06 / 01）

194 - 203

繁體中文

目標：本研究希望藉著瞭解精神分裂症患者使用精神醫療服務與醫療費用相關資料，作為發展精神醫療照護體系的參考。方法：利用國家衛生研院全民健保資料庫抽樣歸人檔，10萬人從1996至2000年全民健保門、住診申報資料，取出精神分裂症患者五年精神醫療住院治療就醫資料進行資料。並以1996至1998年精神分裂症患者第一次就醫門診後滿一年與滿二年就醫資料，進行患者門診與住院醫療利用與費用之分析探討。結果：1996至2000年平均住院日數與平均醫療費用大致呈現下降的趨勢。平均住院日數由40.8天下降為36.0天；平均醫療費用由64089元下降為57276元。1996至1998年第一次門診後滿一年與滿兩年使用門診比率為75.7%與77.9%，平均門診人次為9.0與15.3；使用住院治療比率為10.9與15.4%，再住院率則為10.3%與32.7%。結論：本研究精神分裂症患者之精神醫療服務利用與醫療費用分析結果的資訊可提供檢討精神醫療照護體系改革之用。

Objectives: The objective of this study was to investigate the utilization of psychiatric care of patients with schizophrenia. It hoped that these findings will contribute to the development of the mental health care system. Methods: The study used the claims data of the Bureau Of National Health Insurance (BNHI) from hospitals throughout Taiwan between 1996 and 2000. Results: The average length of stay and average expenditure of hospitalization has a decreased tendency from 40.8 days and 64089 NT dollars in 1996 to 36.0 days and 57276 NT dollars in 2000. During one-year and two-year periods after the first outpatient visit since 1996 to 1998, the proportion of using ambulatory care was 75.7% and 77.9%, respectively, while the average outpatient visit was 9.0 and 15.3, respectively. The admission rates of total subjects were 10.9% and 15.4%, respectively, while the readmission rates were 10.3% and 32.7%, respectively. Conclusions: These study results revealed very important information as guidance to reform mental health care systems.

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