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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 賴美淑 | |
| dc.contributor.author | Shih-Hsien Chan | en |
| dc.contributor.author | 詹士賢 | zh_TW |
| dc.date.accessioned | 2021-06-08T06:57:12Z | - |
| dc.date.copyright | 2009-09-16 | |
| dc.date.issued | 2009 | |
| dc.date.submitted | 2009-07-17 | |
| dc.identifier.citation | American Diabetes Association. Diabetes Statistics, [article online], 2003. Available from: http://www.diabetes.org/home.jsp
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Diabetic Medicine, 22( 8):1031-1036,2005 Tierney EF, Geiss LS, Engelgau MM, Thompson TJ, Schaubert D, Shireley LA, Vukelic PJ, McDonough SL: Populationbased estimates of mortality associated with diabetes: use of a death certificate check box in North Dakota. Am J Public Health 91:84 –92, 2001 Tu EJ. Multiple cause-of-death analysis of hypertension-related mortality in New York State. Public Health Rep: 102(3): 329–335, 1987 Wall MM, Huang J, Oswald J, McCullen D. Factors associated with reporting multiple causes of death. BMC Medical Research Methodology 5:1-13, 2003 Wang S-L, Pan W-H, Hwu C-M, Ho L-T , Lo C-H, Lin S-L, Jong Y-S. Incidence of Diabetes and the effect of gender, obesity and hyperinsulinaemia in Taiwan. Diabetologia: 40:143-8, 1997 Wilkins K, Wysocki M, Morin C, Wood P. Multiple causes of death. Health Reports Statistics Canada: Catalogue 82-003-XPB 9: 2, 1997 Will J C., Vinicora F., and Stevenson J. Recording of diabetes on death certificates: Has it improved? 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Popul Trends 73:1–3, 1993 行政院衛生署中央健保局：全民健康保險慢性疾病範圍。臺北：中央健保局, 1999 吳淑儀 (2007) 應用資料探勘技術於多重死因資料之疾病關聯分析。國立成功大學公共衛生研究所。碩士論文。 呂宗學 為什麼高血壓不是第一大死因？談原死因選擇規則的相關問題。臺灣衛誌, 20:5-14, 2001 呂宗學、衛生署統計室委託研究計畫：實施電腦化原死因系統。(2000/08-2001/01) 呂宗學、衛生署委託研究計畫：死因統計自動化系統品質維謢計畫。(2008/04-2008/12) 高建仁, 高東煒, 陳永煌, 周稚傑, 劉紹興, 羅慶徽 從全民健保資料分析糖尿病患之流行病學與用藥情形。中華職業醫學雜誌, 12(3):187-195, 2005 張順全, 賴美淑, 徐啟庸 臺灣地理區域社經差異與糖尿病患罹病、死亡關聯性探討。醫學科技, 7(2): 140-148, 2005 張瑞泰 & 林健民 癌症、心血管疾病和糖尿病預防。學校衛生, 51:89-102, 2007 陳丹霞(2001) B21肝硬化多重死因分析。中山醫學大學醫學研究所。碩士論文。 陳國東 & 陳建仁. 非胰島素依賴型糖尿病病人死亡狀況及預後因 子。中華衛誌, 16:281-290, 1997 陳朝欽, 雷孟桓 糖尿病人無症狀冠心病的篩檢。內科學誌, 19(3):227-237, 2008 陳靜, 易三三, 徐琳, 袁曉紅. 住院糖尿病患者死因分析。陜西醫學雜誌, 34(7): 807-809, 2005 陳麗華 (2005) ICD-10與多重死因-以糖尿病為例。行政院衛生署研究報告。 劉嘉年, 楊銘欽, 楊志良. 臺灣成年民眾於死亡前三個月健保醫療費用支出之影響因素分析。 臺灣衛誌, 20(6): 451-462, 2001 潘秀丹 & 呂艺. 1992-2004年瀋陽市區民糖尿病死亡趨勢分析。現代預防醫學, 33(2):155-157, 2006 聶義貞, 張一娜, 武小微. 老年糖尿病死亡病例分析。 實用老年醫學, 22(4):272-274, 2008 李美璇等,1999: http://food.doh.gov.tw/foodnew/research/NationalResearch.aspx | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/25931 | - |
| dc.description.abstract | 背景：死因資訊涉及病患家屬私人的權利義務，對死者的親屬而言，死亡證明書是重要的證明文件。經由糖尿病世代死亡多重死因有無提及糖尿病做為探討死亡證明書多重死因填寫品質，有助提升原死因判斷之正確性。
目的：探討糖尿病世代病人死亡之特異性、地理特性、院所屬性、醫療提供、就醫住院與否、就醫診斷個數等，對於多重死因糖尿病提及率之影響。 方法：研究資料源自DOH94-NH-1001衛生署計畫取得糖尿病世代次級資料，以該資料之2002-2005年糖尿病世代病人作為本研究對象，使用單變量邏輯斯迴歸模型、多變量逐步邏輯斯迴歸模型，分析研究對象影響多重死因糖尿病提及率之相關因素。 結果：本研究以2002-2005年糖尿病世代病人(n=20,443人)，其中多重死因有提及糖尿病之比率為39%(n=8,072人)。再按糖尿病世代病人死亡證明書開立院所分組，以醫院為研究對象多重死因有提及糖尿病之比率為36%；以診所為研究對象多重死因有提及糖尿病之比率為47%。對於糖尿病世代病人死亡多重死因糖尿病提及率，死亡證明書開立診所相較於醫院、公立院所相較於私立院所，多重死因較會提及糖尿病。糖尿病世代病人生前一年因糖尿病及心血管疾病、腦血管疾病、腎臟疾病三大合併症就醫次數或費用愈多，多重死因糖尿病提及率愈高。生前一年就醫次數或費用最多院所，與死亡證明書開立院所相同者相較於不同者，多重死因糖尿病提及率較高。 結論：就影響糖尿病世代多重死因糖尿病提及率之相關因素，針對死亡證明書填寫內容的準確性、明確性與對政策之有用性進行檢討評估，發展出例行的標準作業流程來改進死因統計品質。 | zh_TW |
| dc.description.abstract | Background: Death certification is important informaion that was concerned with private right and duty of decedents’ kinsfolk. To assess the quality of the information supplied on the certificate can follow diabetes cohort to death mentioning diabetes on the certificate, and it also will improve accuracy of coding underlying cause of death.
Purpose: This study discussed the relationships of multiple causes of death mentioning diabetes as factors associated with diabetes cohort (specific, geographic, hospitals or clinics, medical utilization, inpatient or outpatient, and a number of medical certificates). Methods: Our sample was diabetes cohort obtained from secondary data (Depatment of heath: DOH94–NH-1001 in 2002-2005). The objectives of this study were to analyze rate of mentioning diabetes on death certificate using logistic model and stepwise multivariable logistic model. Result: Our diabetes cohort sample (n=20,443) was recorded as diabetes on 39% of death certificate (n=8,072). Stratifying by hospitals and clinics, sample mentioning diabetes were 36% in hospitals and 47% in clinics. We found out some factors related to death rate mentioning diabetes. Death certificate from clinics and public institution, more medical utilization (cost or times) at one year age (attributed to cardiovascular, cerebrovascular disease and nephropathy), institutions using most medical utilization, equal institution from between death certification and medical certification were assiociated with death rate mentioning diabetes. Conclusions: To examine the relationship of factors can potentially provide useful information about accuracy of cause of death coding, policy and assessment of health public and developing standard operating procedure to improve recording quality on death certificates. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-08T06:57:12Z (GMT). No. of bitstreams: 1 ntu-98-R96846005-1.pdf: 838679 bytes, checksum: d4b54bc3be9ab1a85c22b865292fd711 (MD5) Previous issue date: 2009 | en |
| dc.description.tableofcontents | 摘要 I
Abstract II 目錄 III 圖目錄 V 表目錄 VI 第一章、緒論 1 第一節、研究背景 1 第二節、研究目的. 4 第二章、文獻回顧 5 第一節、多重死因國內外之優勢與應用 5 (一)多重死因作為資訊提供之優勢 5 (二)國外之經驗 5 (三)國內之經驗 6 第二節、糖尿病患者原死因或多重死因之研究 6 第三節、影響糖尿病患死亡之相關因素探討 8 第四節、多重死因提及糖尿病之影響因素 12 第五節、死因系統之發展與現況 26 (一) 死因系統之發展 26 (二)我國死亡登記作業流程 31 (三)死亡證明書之內容及重要性 32 第三章、材料方法 34 第一節、研究設計 34 第二節、研究資料來源 34 第三節、研究對象 34 第四節、資料處理及研究架構 35 第五節、研究變項與操作型定義 41 第六節、統計方法 48 第四章、研究結果 51 第一節、描述性統計結果 51 （一）以全體院所為研究對象 51 （二）以醫院為研究對象 52 （三）以診所為研究對象 54 第二節、推論性統計分析結果－卡方檢定及t檢定分析 57 （一）以全體院所為研究對象 57 （二）以醫院為研究對象 57 （三）以診所為研究對象 58 第三節、推論性統計分析結果－單變量分析 86 （一）控制變項分析 86 （二）地理特性 88 （三）院所屬性 90 （四）就醫住院與否 90 （五）就醫院所家數 92 （六）就醫診斷個數 92 （七）醫療提供 93 （八）特異性 95 第四節、推論性統計分析結果－多變量分析 97 (一)研究假說1(地理特性)： 97 (二)研究假說2(院所屬性)： 98 (三)研究假說3(就醫住院與否)： 98 (四)研究假說4(就醫院所家數)： 99 (五)研究假說5(就醫診斷個數)： 99 (六)研究假說6(醫療提供)： 100 (七)研究假說7(特異性)： 101 第五節、模型區別力分析 125 第五章、討論與結論 126 參考文獻 129 圖目錄 圖1-1.美國多重死因自動化輸入流程 30 圖1-2.臺灣多重死因中文診斷自動化輸入流程 30 圖2-1.糖尿病世代研究資料庫之建製流程圖 30 圖2-2.排除條件篩選流程圖 38 圖2-3.資料處理流程圖 39 圖2-4.研究架構圖 42 表目錄 表1.多重死因研究之整理 15 表2-1.疾病類別定義 41 表2-2.各合併症之Charlson index權數 42 表2-3.糖尿病併發症診斷代碼及其DCSI權數 43 表3-1.以全體院所為研究對象多重死因有無提及糖尿病與相關自變項基本特性之描述性分析 61 表3-2.以醫院為研究對象多重死因有無提及糖尿病與相關自變項基本特性之描述性分析 609 表3-3.以診所為研究對象多重死因有無提及糖尿病與相關自變項基本特性之描述性分析 78 表4-1.以全體院所為研究對象多重死因有無提及糖尿病與相關自變項之單變量與多變量邏輯斯迴歸分析 103 表4-2.以醫院為研究對象多重死因有無提及糖尿病與相關自變項之單變量與多變量邏輯斯迴歸分析 110 表4-3.以診所為研究對象多重死因有無提及糖尿病與相關自變項之單變量與多變量邏輯斯迴歸分析 118 | |
| dc.language.iso | zh-TW | |
| dc.title | 由多重死因診斷檢視糖尿病世代死亡記載有糖尿病之相關分析研究 | zh_TW |
| dc.title | DM-mentioned multiple cause-of-death analysis of DM cohort’s death certificate in Taiwan | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 97-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 季瑋珠,莊立民,黃旭明,呂宗學 | |
| dc.subject.keyword | 糖尿病世代,多重死因,死亡證明書,生前就醫, | zh_TW |
| dc.subject.keyword | diabetes cohort,multiple cause of death,death certificate,medical certificate, | en |
| dc.relation.page | 132 | |
| dc.rights.note | 未授權 | |
| dc.date.accepted | 2009-07-20 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 預防醫學研究所 | zh_TW |
| 顯示於系所單位： | 流行病學與預防醫學研究所 | |
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