裂孔性視網膜剝離手術後再住院之危險因子

Risk Factors for Postoperative Readmissions of Rhegmatogenous Retinal Detachment: A 3-year population-based study of Taiwan

10.6831/TMU.2008.00034

胡朝乾

裂孔性視網膜剝離 ； 再住院率 ； 全民健康學術研究資料庫 ； rhegmatogenous retinal detachment ； readmission rate ； National Health Insurance Research Database

臺北醫學大學醫務管理學研究所學位論文

2008年

碩士

林恆慶副教授

繁體中文

研究對象與方法: 本研究資料來源是國家衛生研究院釋出之「全民健康學術研究資料庫」，研究對象為2001年初至2003年底全國裂孔性視網膜剝離的住院病人以及執行手術的醫師、醫院。自變項包括病人特質、醫院特質、醫師特質、手術方法特質。依變項為手術結果，以再住院率作為結果指標。 結論: 從2001至2003年之間，臺灣地區裂孔性視網膜剝離共有10,852例，其中有652例於出院後三十天內再住院，百分比為6.01%。有2011例於出院後三百六十五天內再住院，百分比為18.53%。 本國裂孔性視網膜剝離患者術後三十天的再住院結果：短期再住院率男性高於女性，老年人高於年青人。住院日數在3日內者再住院率最高。公立醫院與南區、東區醫院再住院率較高。年齡 ≥46歲的醫師所開刀的病人再住院率最低。醫師三年服務量80台以下的再住院率最高。其他手術的再住院率明顯高於鞏膜扣壓術，玻璃體切除術與鞏膜扣壓術加玻璃體切除術三組。 本國裂孔性視網膜剝離患者術後三百六十五天的再住院結果：長期再住院率男性高於女性，老年人高於年青人。住院日數超過11日以上者再住院率最高。公立醫院與中區、南區醫院再住院率較高。醫師年齡與服務量的差異對再住院率並無明顯影響。其他手術的再住院率明顯高於另外三組。

Patients and Methods: This study was based on the National Health Insurance Research Database of Taiwan. The data contained nation-wide claim data started from January 2001 to December 2003. All the patients admitted to hospital for surgery with the principal diagnosis of rhegmatogenous retinal detachment (ICD 9 CM: 361.0) were recruited in this study. The outcome indicator was 30-day and 365-day readmission rates after the surgery. Various factors (including factors of patients, hospitals, surgeons and operative methods) which may possibly have any influence on the outcome were studied and analyzed. The logistic regression analysis was used to evaluate the impact of these factors. Conclusion: From January 2001 to December 2003, there were 10,852 cases of rhegmatogenous retinal detachment admitted to hospital for surgery in Taiwan. Among them, 652 cases (6.01%) were readmitted for further treatment with the same diagnosis within 30 days ; 2.011 cases (18.53%) were readmitted within 365 days. Risk factors for 30-day postoperative readmissions were listed below: male patients, older patients, length of stay within 3 days, public hospital, southern and eastern area of Taiwan, surgeon’s age younger than 46 years old, surgeons with three-year volume less than 80 cases, surgical methods other than scleral bukling and pars plana vitrectomy. Risk factors for 365-day postoperative readmissions were listed below: male patients, older patients, length of stay more than 11 days, public hospital, central and southern area of Taiwan, surgical methods other than scleral bukling and pars plana vitrectomy.

1. 張琝蓁(2016)。原發性視網膜剝離病人術後醫療品質之研究。義守大學醫務管理學系學位論文。2016。1-69。