Applying ACG system to Evaluate the Disease Burdens and edical Utilizations among the Disadvantaged Group in Elderly Patients

• Main Authors: Li-Hsun Huang, 黃麗薰
• Other Authors: Wui-Chiang Lee
• Format: Others
• Language: zh-TW
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/80463118697468998017

碩士 === 國立陽明大學 === 醫務管理研究所 === 97 === This study is to evaluate the relationship between disease burden, health care cost and medical utilization of the disadvantaged people by means of adjusted clinical group. The disadvantaged include low-income individuals, veterans, mountain and off-shore islands residents and handicaps who are aged over 65 years old, and then we sequentially separate them into four different groups (aged between 65-69, 70-74, 75-79 and over 80 years old). We analysis their ACG group, numbers of ADG (Aggregated diagnosis group) and major ADG, also their relationships with medical expenditure and utility were studied. The data resource of our study is National Health Insurance Database which is provided by National Health Research Institutes, A total of 18,478 individuals were included. The frequency of out-patient clinic visits is higher for female than male patients, but the hospital stays, expenditure of out-patient clinic and hospitalization, were higher in male patients. Average expenditure and frequency of out-patient clinic visits are higher at the group of aged between 75 and 79, but the average hospitalization cost and hospital stays are higher while age is older. The low-income elders have the highest hospital stay in all disadvantaged groups, but the elder handicaps have the highest frequency of out-patient clinic visits, expenditure of out-patient clinic and hospitalization. This means the major factor associated with health care utilization is disease burden, the weakness of individual’s economic status doesn’t affect the accessibility of health care. We find out that the medical expenditure and utility are higher in disadvantaged elders when compared with average elders, also the handicaps and low-income elders have higher medical expenditure. The more numbers of ADG types and major ADGs individuals have, the higher disease burden they are, also the more health care cost and utilization they use. We conclude that it is feasible to evaluate the disease burden of elders and to analyze or predict their medical demand.