| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 94 === Abstract
Background:Chronic Obstructive Pulmonary Disease, COPD includes Chronic Bronchitis and Pulmonary Emphysema that are commonly seen disease for middle and old age person that is mainly caused by smoking. Following the aging population and increase in smoking percentage and air pollution, the rate of obtaining COPD continues to be high. In 2003, the prevailing rate of COPD in Taiwan is 6.77% and adult over 40 is as high as 16%. In 1988 such disease is the fourth largest cause of death in USA and it is estimated that it may become the third largest cause of death in the world. This will result in serious medical resource consumption and social health problem.
Purpose: Study is conducted on different patient characteristic and the characteristic of hospital for resource utilization of inpatient COPD, and the difference in the inpatient fee and the length of stay. This can serve as a reference for disease prevention and reasonable control of medical resource utilization.
Method:The data on the hospitalization reported by the NHI in 2004 is utilized the traditional definition of COPD on the inpatients diagnosed as main and secondary 491, 492 and 496 patient registered in the ICD-9-CM and patients under 40 are excluded as research target.
Result: The entire health insurance expense reported for COPD in 2004 in Taiwan is about 5.328 billion dollars, the average length of stay is 13.3 days and the average inpatient fee is 49,474 dollars. In respect of length of stay is high, when the level of seriousness of comorbidity is high, more patients with disease complication, usage of respirator for treatment and medical treatment in regional teaching hospital, public hospital and Taipei. In respect of inpatient fee is high, when the level of seriousness of comorbidity is high, more patients with disease complication, usage of respirator for treatment and medical treatment in medical center, public hospital, private hospital and Taipei. It shows that there is significant effect on the length of stay and inpatient fee for COPD patient by the characteristics of disease, level of the medical treatment organization, authority type and district type. Amongst these, the power of influence of medical treatment by respirator is the largest. The sex variable of patients shows a significant correlation on inpatient fee. For age variable, there is no significant effect on the consumption of medical resource.
Suggestion: Health unit and hospital manager should actually implement tobacco hazard prevention and disease health education work so as to reduce the impact on the health of our citizen by COPD.
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