大規模冠狀病毒流行對台灣中醫使用及醫療花費之影響

Impact of Large-Scale Coronavirus Epidemic on the Use of Traditional Chinese Medicine and Medical Costs in Taiwan

10.6516/TJTCM.202006/SP_23.0006

王明仁(Ming-Jen Wang)；林家琳(Chia-Lin Lin)；周暉哲(Hui-Zhe Zhou)；王品軒(Pin-Hsuan Wang)；林舜穀(Shun-Ku Lin)

冠狀病毒 ； 大規模流行 ； 台灣 ； 中醫 ； 使用率 ； 醫療花費 ； Coronavirus ； large-scale epidemic ； Taiwan ； traditional Chinese medicine ； utilization rate ； medical cost

中醫藥研究論叢

23卷特刊（2020 / 06 / 30）

83 - 93

繁體中文

前言：大規模冠狀病毒流行是二十一世紀全球公共衛生的重大挑戰，從2003年嚴重急性呼吸道症候群（Severe Acute Respiratory Syndrome, SARS）疫情開始，一系列的疫情傳播對公共衛生和醫療體系造成巨大的衝擊。中醫作為醫療體系的一部分，在疫情來臨時也須做出適當的因應，以提供民眾更好的醫療照顧。但大規模冠狀病毒流行對中醫利用率的影響仍未有研究觸及。本研究旨在探討大規模冠狀病毒流行對中醫使用率及醫療花費的影響，以及不同性別、年齡等不同族群在疫情期間中醫使用率的變化。方法：本研究為回溯性世代研究，我們使用全民健康保險百萬人抽樣資料庫，擷取於2000～2004年間中醫就醫資料已進行分析。本研究將於百萬人抽樣檔中，篩選有接受過中醫治療的台灣全民健康保險就醫資料，包含就醫人次與中醫花費，並依照不同性別、年齡及中醫院所等級分別分析。結果：我們共納入了64,196,836筆中醫門診資料，其中2002年共13,357,263筆，2003年則有14,554,405筆。我們發現嚴重急性呼吸道症候群流行期間，中醫門診就醫人次上升而針灸人次下降。在疫情最嚴重的五月份，中醫總人數上升1.3%，相反的針灸人數下降5.1%。年紀較輕的患者在疫情期間門診人數下降較多；醫院附設的中醫科門診人數大幅下降，而中醫診所的門診人數則顯著上升。中醫醫療整體花費在大規模流行期間穩定上升，但部分負擔則下降。結論：本研究發現大規模冠狀病毒疫情會顯著影響台灣中醫的使用率及醫療花費，對於不同年齡患者及不同中醫院所影響亦有差異。

Introduction: The large-scale coronavirus epidemic is a major global public health challenge in the 21st century. Since the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic has caused a huge impact on public health and medical systems. Traditional Chinese medicine (TCM), as part of the medical system, must also respond appropriately when the epidemic occurs to provide better medical care for the people. However, the impact of large-scale coronavirus epidemic on the utilization rate and quality of traditional Chinese medicine has not been touched by research. The purpose of this study was to investigate the impact of large-scale coronavirus epidemic on the utilization rate and cost of traditional Chinese medicine, as well as the changes in the utilization rate of traditional Chinese medicine among different ethnic groups such as gender and age during the epidemic. Method: This study is a retrospective cohort study. We used a sample database of millions of people from the Health and Welfare Data Science Center. We analyze the data of traditional Chinese medicine treatment from 2000 to 2004. In this study, a sample file of millions of people will be screened to select medical information of Taiwan National Health Insurance who have received Chinese medical treatment, including the date of medical treatment, diagnosis, treatment, and cost. We will analyze the changes in the utilization rate of TCM and medical expenses from March 2003 to September 2003, and the results compared with last year. Results: We included 64,196,836 TCM outpatient data, of which 13,357,263 were in 2002 and 14,554,405 in 2003. We found that during the epidemic of the severe acute respiratory syndrome, the number of outpatient visits in TCM clinics increased while the number of acupuncture visits declined. In May, when the epidemic was the worst, the total number of Chinese medicine surged by 1.3%, while the number of acupuncture fell by 5.1%. The number of outpatients of younger patients decreased more during the epidemic; the number of outpatients in Chinese medicine departments attached to the hospital dropped significantly, while the number of outpatients in Chinese medicine clinics increased significantly. Conclusion: This study found that a large-scale coronavirus epidemic significantly affects the utilization rate and medical cost of Taiwanese traditional Chinese medicine, and has different effects on patients of different ages and diagnoses.

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