請用此 Handle URI 來引用此文件：
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/37322完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 楊銘欽(Ming-Chin Yang) | |
| dc.contributor.author | Chien-Chung Lai | en |
| dc.contributor.author | 賴建仲 | zh_TW |
| dc.date.accessioned | 2021-06-13T15:24:24Z | - |
| dc.date.available | 2010-01-01 | |
| dc.date.copyright | 2008-08-14 | |
| dc.date.issued | 2008 | |
| dc.date.submitted | 2008-07-21 | |
| dc.identifier.citation | 英文部分
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Journal of Laryngology & Otology 110(8): 732-5. Ramsey, S. D. and S. D. Sullivan (2003). 'The burden of illness and economic evaluation for COPD.' Eur Respir J Suppl 41: 29s-35s. Reed, S. D., T. A. Lee, et al. (2004). 'The economic burden of allergic rhinitis: a critical evaluation of the literature.' Pharmacoeconomics 22(6): 345-361. Reissman, D., T. Price, et al. (2004). 'Cost efficiency of intranasal corticosteroid prescribing patterns in the management of allergic rhinitis.' J Manag Care Pharm 10(1 Suppl): S9-13. Rhee, C. S., D. Y. Kim, et al. (2001). 'Changes of nasal function after temperature-controlled radiofrequency tissue volume reduction for the turbinate.' Laryngoscope 111(1): 153-8. Rienzo, V. D., F. Marcucci, et al. (2003). 'Long-lasting effect of sublingual immunotherapy in children with asthma due to house dust mite: a 10-year prospective study.' Clinical & Experimental Allergy 33(2): 206-210 Sandhu, A. S., R. H. Temple, et al. (2004). 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'Cost-benefit analysis of first-generation antihistamines in the treatment of allergic rhinitis.' Pharmacoeconomics 22(14): 929-942. Takeno, S., R. Osada, et al. (2003). 'Laser surgery of the inferior turbinate for allergic rhinitis with seasonal exacerbation: an acoustic rhinometry study.' The Annals Of Otology, Rhinology, And Laryngology 112(5): 455-460. Tokano, H., H. Maehara, et al. (2005). 'Short-term effect of argon plasma coagulation of the inferior turbinate in patients with perennial nasal allergy.' Auris, Nasus, Larynx 32(2): 145-150. Wiesmiller, K., T. Keck, et al. (2006). 'Nasal air conditioning in patients before and after septoplasty with bilateral turbinoplasty.' Laryngoscope 116(6): 890-4. Wilson, D. R., M. T. Lima, et al. (2005). 'Sublingual immunotherapy for allergic rhinitis: systematic review and meta-analysis.' Allergy 60(1): 4-12. Wu, C.-C., S.-Y. Lee, et al. (2008). 'Patients with positive allergen test have less favorable outcome after endoscopic microdebrider-assisted inferior turbinoplasty.' American Journal of Rhinology 22(1): 20-3. 中文部分 宋霖霏, 林昌誠, et al. (2005/05). '全民健保鼻中膈鼻道成形術論病例計酬制對醫療資源使用之影響.' 北市醫學雜誌 2(5): 465-474 陳渼雅 (2005 ). 以全民健保2000–2003年承保抽樣歸人檔分析過敏性鼻炎患者之醫療利用情形及其相關因素. 醫療機構管理研究所 台北市, 臺灣大學. 碩士: 111. 陳穆寬, 張正權, et al. (2003/04). '微創性黏膜下鼻甲整形術－初報.' The Changhua Journal of Medicine 8(2): 71-75. 曾憲彰, 鄭元凱, et al. (2002/01). '以射頻縮減下鼻甲組織體積治療慢性鼻塞.' 中華民國耳鼻喉科醫學雜誌 37(1): 22-27. 戴志展, 王拔群, et al. (2002/09). '鼻中膈鼻道成形術論病例計酬制實施之影響評估.' Mid-Taiwan Journal of Medicine 7(3): 165-171. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/37322 | - |
| dc.description.abstract | 目的：比較兩種過敏性鼻炎（AR）的手術輔助治療─ 雷射下鼻甲成形術（LT）和鼻中膈鼻道成形術（SMP），旨在：1.運用經濟評估比較各術式的效果及效益；2.探討影響效果及效益的主要預後因子。
方法：次級資料分析同組研究。運用全民健保資料庫2001至2004年承保抽樣歸人檔，選出因AR在耳鼻喉科接受LT或SMP者，以術前6或12個月為比較基期，排除術前6或12個月未曾因AR至門診就醫者。篩出符合者之所有AR門診申報記錄，並計算其手術前後各區段之總門診費用及次數。「成本」為手術當次門診或住院之合計金額，「效益」為術後節省的門診費用，「效果」為術後節省的門診次數。其它變項包括「手術」、「性別」、「年齡」、「術前門診費用」，和「術前門診次數」。最後，運用迴歸分析探討影響效果及效益的主要預後因子，並使用經濟評估的方式比較方案間的差異。 結果：若以6個月為區間，共有122位病患（LT 110人; SMP 12 人）。LT平均成本為4571.30元，平均效益成本比（BCR）為0.34，平均成本效果比（CER）為2401.22（元/次）；SMP平均成本為23808.33元，平均BCR為0.07，平均CER為10801.84（元/次）。若以12個月為區間，共有109位病患（LT 98人; SMP 11人）。LT平均成本為4635.90元，平均BCR為0.42，平均CER為1889.41（元/次）；SMP平均成本為23649.18元，平均BCR為0.09，平均CER為8715.98（元/次）。性別、年齡、術前門診費用、術前門診次數、效益，與效果等在LT和SMP兩組中並無顯著不同。但成本以SMP較高。LT和SMP均能減少術後的AR醫療費用，然而LT相對於SMP有較佳的成本效益比，而且在術後2年的追踪期間內LT同SMP仍維持其效益。術前門診次數是效果的主要預後因子；術前門診費用則是效益的主要預後因子。 結論：長期AR如果藥物治療鼻塞效果不佳，可施行輔助治療手術減輕症狀。若僅有下鼻甲肥厚LT應是首選，其治療過程較舒適、有較佳的成本效益比且持續的效果可逹2年以上。倘若合併有致病性的鼻中膈彎曲，可考慮SMP治療。 | zh_TW |
| dc.description.abstract | Objective: To compare outcomes for laser turbinoplasty (LT) and septomeatoplasty (SMP) for allergic rhinitis (AR).
Methods: Secondary analysis was performed of National Health Insurance data from patients with AR who underwent LT or SMP from 2001 to 2004. Outcomes were defined as follows: cost was inpatient or outpatient expenditures for surgery, benefit was saved postoperative outpatient expenditures, effectiveness was the number of postoperative outpatient visits saved. Results: Over 6 months, there were 122 patients: 110 for LT and 12 for SMP. For LT, the average cost, benefit-cost ratio (BCR), and cost-effectiveness ratio (CER) were NT$4571.30, 0.34, and NT$2401.22 per visit, respectively. For SMP, the average cost, BCR, and CER were NT$23808.33, 0.07, and NT$10801.84 per visit, respectively. Over 12 months, there were 109 patients: 98 for LT and 11 for SMP. For LT, the average cost, BCR, and CER were NT$4635.90, 0.42, and NT$1889.41 per visit, respectively. For SMP, the average cost, BCR, and CER were NT$23649.18, 0.09, and NT$8715.98 per visit, respectively. LT provided more appropriate BCR and CER than SMP. Preoperative outpatient visits were the major prognostic determinant for effectiveness. Preoperative outpatient expenditures were the major prognostic determinant for benefit. Conclusions: LT should be considered first to alleviate nasal obstruction refractory to medication if only chronic hypertrophic inferior turbinates are present. However, SMP would be more appropriate if additional pathologic deviation of the nasal septum is observed. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-13T15:24:24Z (GMT). No. of bitstreams: 1 ntu-97-P95843012-1.pdf: 821112 bytes, checksum: 7b435466306a8848eb66a374576f8863 (MD5) Previous issue date: 2008 | en |
| dc.description.tableofcontents | 口試委員會審定書 i
誌謝 ii 中文摘要 iii ABSTRACT iv 第一章 緒論 第一節 研究的背景 1 第二節 研究的目的 2 第三節 研究的重要性 2 第二章 文獻探討 第一節 過敏性鼻炎及其治療 3 第二節 過敏性鼻炎的輔助治療手術 5 第三節 過敏性鼻炎的經濟評估 8 第四節 綜合評論 12 第三章 研究材料與方法 第一節 研究設計 13 第二節 研究架構 14 第三節 研究假說 14 第四節 研究變項 15 第五節 資料處理 16 第六節 資料分析 18 第四章 研究結果 第一節 描述性統計分析 22 第二節 複迴歸分析 25 第三節 簡單迴歸線性分析 26 第四節 經濟評估 27 第五章 討論 第一節 資料品質 55 第二節 研究結果之討論 56 第三節 研究限制 59 第六章 結論與建議 第一節 結論 60 第二節 建議 61 參考文獻 63 附錄 69 | |
| dc.language.iso | zh-TW | |
| dc.subject | 鼻中膈鼻道成形術 | zh_TW |
| dc.subject | 過敏性鼻炎 | zh_TW |
| dc.subject | 全民健保 | zh_TW |
| dc.subject | 次級資料分析 | zh_TW |
| dc.subject | 經濟評估 | zh_TW |
| dc.subject | 雷射下鼻甲成形術 | zh_TW |
| dc.subject | Allergic rhinitis | en |
| dc.subject | Septomeatoplasty | en |
| dc.subject | Laser turbinoplasty | en |
| dc.subject | Economic evaluation | en |
| dc.subject | Secondary analysis | en |
| dc.subject | National Health Insurance | en |
| dc.title | 過敏性鼻炎手術方法之經濟評估—雷射下鼻甲成形術與鼻中膈鼻道成形術之比較 | zh_TW |
| dc.title | Economic Evaluation of Adjuvant Surgical Therapy for Allergic Rhinitis- Comparing Laser Turbinoplasty with Septomeatoplasty | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 96-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 李玉春(Yu-Chun Lee),張睿詒(Ray-E Chang) | |
| dc.subject.keyword | 過敏性鼻炎,全民健保,次級資料分析,經濟評估,雷射下鼻甲成形術,鼻中膈鼻道成形術, | zh_TW |
| dc.subject.keyword | Allergic rhinitis,National Health Insurance,Secondary analysis,Economic evaluation,Laser turbinoplasty,Septomeatoplasty, | en |
| dc.relation.page | 70 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2008-07-22 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 醫療機構管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
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