睡眠障礙合併酒癮住院流行病學特性與重複住院影響因子

EPIDEMIOLOGY OF SLEEP DISORDERS IN ALCOHOLIC INPATIENTS AND THEIR HOSPITAL FACTORS OF HOSPITAL READMISSION

10.6338/JDA.202010_15(5).0001

宋婕(Chieh Sung)；林富煌(Fu-Huang Lin)；簡戊鑑(Wu-Chien Chien)；鍾其祥(Chi-Hsiang Chung)；吳彧(Daphne Ng Yih)

睡眠障礙 ； 酒癮 ； 全民健保資料庫 ； 重複住院 ； sleep disorder ； Alcoholism ； National Health Insurance Research Database ； readmissions

Journal of Data Analysis

15卷5期（2020 / 10 / 01）

1 - 20

繁體中文

睡眠是促進健康重要因素，長期睡眠障礙患者因為無法入睡或易醒等因素，可能影響患者本身行為（如：酒癮），臨床上常見到睡眠障礙患者喝酒以助眠，因安眠作用逐漸降低而增加酒量，停酒後戒斷症狀導致更嚴重睡眠障礙，使其不得不增加酒量以助眠，若持續的飲酒幫助睡眠，則會造成相同問題的重複入院。本研究利用全民健保資料，使用次級資料（secondary data）分析方式，分析睡眠障礙合併酒癮個案重複住院之影響因素，以SPSS 22.0版統計軟體作為分析工具並以獨立樣本t檢定（t-test）、卡方檢定（chi-square test）、羅吉斯回歸（logistic regression）來檢定，睡眠障礙合併酒癮在性別、年齡層及原因別上的差異及相關情形以及重複住院影響因子。研究結果顯示，台灣2000－2013年住院病患睡眠障礙合併酒癮者共2827人（男性：2487人、女性：340人），平均年齡為42.93±10.65歲，年齡層以25-44歲1704人（60.3%）比例最高，地區部分則以高雄市469人為最多，經羅吉斯回歸（logistic regression）校正變項後，發生睡眠障礙合併酒癮重複住院影響因子中，低收入戶發生重複住院的風險為非低收入戶的6.70倍（p＜0.001，95%CI：4.67～9.62）；重大傷病患者發生重複住院的風險為非重大傷病患者的1.84倍（p＜0.001，95%CI：1.40～2.42）；東部地區（包含外離島）是北部地區患者的1.80倍（p＜0.001，95% CI：1.22～2.65）。2000-2013年睡眠障礙合併酒癮重複住院影響因子有低收入、重大傷病及居住在東部地區（包含外離島），本結論對於台灣公共衛生與醫療體系而言，可作為醫療資源分配的考量，以及未來可考慮於醫療院所與職場，針對睡眠障礙酒癮者進行相關介入措施，降低重複住院情形。

Sleep is a crucial factor in promoting health. Patients with long-term sleep disorders may be unable to fall asleep or may awaken from sleep. Sleep disorders can adversely affect patient behavior and cause alcoholism. Patients with clinical insomnia often drink alcohol to fall asleep. When patients reduce their alcohol consumption because of improved sleep and eventually stop drinking, the alcohol withdrawal symptoms result in more severe insomnia; consequently, the patients increase their alcohol consumption to enable themselves to fall asleep. If alcohol consumption is repeatedly used to facilitate sleep, patients are often admitted to hospitals for the same sleep-related problems. The present study uses data from the universal National Health Insurance Research Database. Secondary data were used to analyze the factors affecting readmission of patients with sleep disorders and alcohol addiction. SPSS 22.0 was used for statistical analysis. Independent test t-tests, chi-square tests, and logistic regression were used to determine significant differences in sex, age, causes of sleep disorders, causes of alcohol addiction, alcohol-addiction-related factors, and factors affecting readmission. The results showed that a total of 2,827 patients with sleep disorders and alcohol addiction were hospitalized from 2000 to 2013 in Taiwan. The average patient age was 42.93 ± 10.65 years, and the highest number of patients (1,704) was observed in the 25-44-years age group. Furthermore, most patients (469) were residents of Kaohsiung City. After logistic regression and adjusting for the causes of sleep disorders and alcohol addiction, patients from low-income families had a readmission risk 6.70 times higher than that of patients from high-income families. The readmission risk of patients with major illnesses was 1.84 times higher than that of patients without major illnesses. The readmission risk of patients from eastern Taiwan (including the outer islands) was 1.80 times higher than that of patients from northern Taiwan. During the period 2000-2013 in Taiwan, repeated hospitalization for sleep disorders and alcohol addiction were affected by factors, such as low family income, major illnesses, and location of residence.

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