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台灣老人皮膚病門診服務的使用:全國剖析

Dermatological Outpatient Services Utilization among the Elderly in Taiwan: A National Profile

摘要


本研究藉由分析全國老人皮膚科門診服務之使用,並檢驗其在年齡、性別、城鄉別、失能程度、和居住照護機構(護理之家或養護機構)與否等特質的差異。研究樣本為來自全國204個鄉鎮市區140,738位65歲以上老人的隨機樣本,面對面調查其人口特質,並抽取其在2001年7月到2002年6月間因皮膚病而看健保門診的申報資料,進行各診斷別服務使用之敘述性分析,以卡方檢定、t檢定、變異分析等進行雙變項之差異檢定,以邏輯斯複迴歸進行使用機率差異之多變項分析。結果發現,老人因皮膚病而使用門診服務的年使用率為32.57%。邏輯斯複迴歸分析發現,年紀較大(1.20, 1.17~1.23)、男性(1.11, 1.09~1.14)、居住照護機構(2.10, 1.88~2.34)等是影響門診服務使用的顯著危險因子,重度失能者(0.86,, 0.82~0.91)顯著少用門診服務。各診斷別中,最多因感染性皮膚病(14.47%)與濕疹皮膚病(13.22%)而就醫。感染性皮膚病的診斷以細菌與黴菌為主。男性與居住照護機構顯著較多因感染性皮膚病而就醫。濕疹類皮膚病則以因全身性濕疹而就醫者佔最多比例,男性與居住照護機構也同樣較多因該診斷而就醫。失能程度越重和因皮膚潰瘍而就醫的比率成正比,相較於功能正常者,具有3項以上ADL障礙者因皮膚潰瘍而就醫的比率的勝算比高達7.45(95%CI=6.22-8.92)。 結論:透過全國性分析台灣老年人口的皮膚科疾病與門診服務使用,可以了解影響老年人皮膚病門診服務使用之因素,提供未來我國皮膚科服務因應人口老化的發展之參考。

關鍵字

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並列摘要


The purpose of the study was to analyze the characteristics of outpatient services utilization of skin diseases among geriatric population in Taiwan. Data from a population-based random sample consisted of 140,738 elderly patients from a national survey was used for analysis. Information regarding individual characteristics was collected by personal interview. Information regarding utilization of outpatient services due to skin diseases by the sample was collected from the claim records of National Health Insurance from July 2001 to June 2002. χ^2 tests, t-tests, or ANOVA were used for bivariate analysis, and multiple logistic regression for multivariate analysis. Results showed that the utilization rate of outpatient services due to skin diseases for the elderly was 32.57%. Older age (OR, 1.20; 95% CI, 1.17~4.23), male gender (1.11, 1.09~1.14), and institutionalization (2.10, 1.88~2.34) were significant risk factors for dermatology outpatient service utilization. Severe disability (0.86, 0.82~0.91) was negatively associated with services use. Infection and eczema were the two most common diagnostic categories, and were associated with male gender and institutionalization. Patients with 3 or more ADL disabilities were associated with the highest risk for skin ulcer (7.45, 6.22~8.92). Findings of this study may cast implications on health policy for dermatologic care of the growing aging population.

被引用紀錄


顧勝敏(2011)。台灣高齡老人的醫療服務使用情形〔碩士論文,中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834/CSMU.2011.00177
吳玉玲、高毓秀(2014)。多媒體輔助教學介入對長期照護機構照顧服務員皮膚照護學習成效之研究護理雜誌61(4),26-34。https://doi.org/10.6224/JN.61.4.26
陳首誌(2012)。應用資料探勘於皮膚疾病之研究與實作〔碩士論文,崑山科技大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0025-1502201216581700
楊惠真(2012)。護理之家照顧服務品質之多層級分析_以中部地區四縣市為例〔博士論文,國立中正大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0033-2110201613502035

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