| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 95 === Abstract
Objectives：Pneumoconiosis, along with its related complications, is the most common cause of occupational handicap and mortality in Taiwan. Depression is a critical issue that has great impact on the quality of life and medical expenditure but little is studied about depressive mood in patients with pneumoconiosis in Taiwan. The main purpose of this study is to examine the correlation of depression, pneumoconiosis and their medical expenditure. Methods：We collect all patients who were diagnosed as pneumoconiosis by a district hospital at northern Taiwan from January till December of 2001, all of them were evaluated with Taiwan Geriatric Depression Scale (TGDS) to decide their state of mood. The expenditure of outpatients and inpatients either had diagnosis of pneumoconiosis was also collected. Result：One hundred and eighty one patients were included in our study and 46.96% of them had depressive tendency, this incidence was higher than the community-dwelling elderly. The mean and medium expenditure of outpatients, numbers of outpatients visiting hospital and total expenditure were higher in patients with pneumoconiosis than in age-matched patients without pneumoconiosis. Also depressive tendency demonstrated significant influences on outpatients’ expenditure. Patients had pneumoconiosis, cardiovascular disease and psychiatric disease demonstrated significant influences on both outpatients’ and inpatients’ expenditure. Conclusion：Beside pulmonary function and related symptoms, we should consider the impact of mood disorder and comorbidity on the quality of life while treating patients with pneumoconiosis. Since the medical expenditure of the patients with pneumoconiosis is relatively high, we suggest applying the pay-by-quality program to secure their quality of medical care.
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