| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 99 === Background:
The progress of medical technology enables patients’ vital sign to be controlled. But it also induces some other problems, and among which an important one is nosocomial infections. The most common healthcare-associated infection in Taiwan is urinary tract infection. The past study showed catheter-related urinary tract infection (CAUTI) accounted for 29% to 45% of all healthcare-associated infections. And other past study showed 80% of CAUTI is caused by the catheter. The studies hope to understand the CAUTI risk factors and medical utilization.
Objectives:
Title of thesis is The Utilization of catheter-associated urinary tract infections in Taiwan. This study has two major purposes: First, to understand the risk factors of infection the CAUTI. Second, to understand the utilization of CAUTI in Taiwan.
Methods:
This thesis is cross-sectional study. We collect declared information from bureau of national health insurance of patient in 2004 to 2006 which is provided by National Health Research Institutes, including underwriting file, CD, DD, OO, DO and HOSB files. We select all use catheter patients in 2005, and then exclude use catheter and UTI in 2004. To analyze sex, age, diagnosis, hospital-level and disease of burden factors how to impact CAUTI patient medical utilization. When patients has CAUTI, they disease burden over 1.9676 than those not has CAUTI.
Results:
The study shows the incidence rate of CAUTI is 4.6%. The influence CAUTI factors have age-level(0-34, 35-49, 50-64, 65-74 and more than 75), gender, diagnosis, department(medicine, surgery and other),disease of burden and hospital-level, there were statistically significant difference (p-value < 0.001). Then comorbidity (0, 1, 2, more than 3) not statistically significant difference in not ICU group (p-value > 0.05). But comorbidity has more than 3 been statistically significant difference in ICU group (p-value < 0.001). By using generalized linear model, we found that the patient of CAUTI increased the outpatient, inpatient, emergency fee and prolonged the length of stay. The has CAUTI patient's use service (9.1%) and cost (12.5%) more then not has CAUTI patient's in outpatient. The CAUTI patient's use service (21.7%) and cost (22.9%) in emergency, and the inpatient-day (54.7%) and cost (46.1%) in inpatient. Their were statistically significant difference (p-value < 0.001).
Conclusions:
When the patient has high disease of burden will increase the risk of CAUTI. The infectious diseases, endocrine and metabolism diseases and age of patients have high risk of CAUTI. If patients who has CAUTI or high disease of burden, they utilization of medical resources will rise. Their use the emergency treatment and inpatient costs relatively high.
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