| Summary: | 碩士 === 高雄醫學大學 === 醫務管理暨醫療資訊學系碩士在職專班 === 102 === Purpose
Increasing incidence and mortality by years has been reported in patients with malignant lymphoma according to Taiwan’s Ministry of Health and Welfare statistic, 2011. Malignant lymphoma has been the 9th leading cause of death in Taiwan and the most common cause of death in all hematologic malignancies. The purpose of this study was to investigate the impacting factor of medical utilization and survival in lymphoma patients.
Methods
A retrospective study was performed by chart review between 2006 and 2013. The demography、disease characteristics and treatment were recorded. Medical utilization and cost were retrieved from the reimbursement data from the division of medical information. The data were recorded and statistically analyzed using SPSS version 20.0 software. ANOVA、linear regression analysis were performed to compare the difference among groups. Kaplan-Meier survival analysis was done for survival analysis.
Results
A total of 448 patients with lymphoma with median age was 57 years were enrolled for study. B cell lymphoma account for the major type of lymphoma. 53.3% of patients accepted target treatment. The medical utilization showed a average use of 27 days of hospitalization, 57 times of outpatient visits and total medical cost of 457,460 dollars per person. There was a positive correlation between high CCI level、presence of hepatitis B carrier and using of target therapy and chemotherapy and medical utilization. No signification difference in histological pattern was noted. The 5-years survival rate is 60%, which is longer in female than that of male. The patients’ LDH and β2-Microglobulin level before treatment were significant factors to affecting their survivals.
Conclusion and suggestion
Our results showed sex、cancer stage、LDH and β2-Microglobulin level、chronic hepatitis B carrier affecting the medical utilization and survival rate of patients with lymphoma. Higher medical utilization was noted in patients with stage IV、high level of LDH and β2-Microglobulin、chronic hepatitis B carrier and high IPI score. Age, LDH and β2-Microglobulin level were independent factors to predict patient’s survival. Further study is needed for its causal effect.
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