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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 何?芳 | |
dc.contributor.author | Chia-Wei Wu | en |
dc.contributor.author | 吳家瑋 | zh_TW |
dc.date.accessioned | 2021-06-15T06:03:22Z | - |
dc.date.available | 2015-09-13 | |
dc.date.copyright | 2010-09-13 | |
dc.date.issued | 2010 | |
dc.date.submitted | 2010-08-16 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/47506 | - |
dc.description.abstract | 研究背景:
過去國內、外皆有針對高診次族群或老年門診處方適當性之研究,但國內以全民健保研究資料庫探討門診處方適當性之研究係以分析單張處方為主,無法符合病人實際用藥情況。過去文獻指出,高診次族群以老年人居多,但因缺乏文獻探討,老年高診次族群與門診處方適當性兩者之關聯性尚未證實。 研究目的: 瞭解國內老年高診次族群概況與相關因子,以及老年門診處方之適當性,並以病人為主軸,整合其藥歷,以探討老年門診處方之適當性。同時分析處方適當性與高診次行為之相關性,並追蹤其臨床結果。 研究方法: 以全民健康保險研究資料庫2002年至2008年之百萬承保抽樣歸人檔(LHID2005)進行分析。研究對象為各年度65歲以上之納保人(含門診就醫人次為0者)。本研究定義高診次族群為年就診50人次以上者。研究分四階段:(一)老年高診次族群敘述性分析;(二)多變項迴歸分析老年高診次族群之相關因子;(三)以病人為主軸,整合其跨診次、科別以及醫療院所之歷年藥歷,藉此分析老年門診處方之適當性(重複用藥、老年高風險藥品與藥品交互作用);(四)多變項迴歸分析後續臨床結果(翌年就診、急診、住院人次與翌年住院總天數)。 研究結果: 本研究納入113,476人,共分析610,005人(各年度研究對象總合),門診就醫診(簡稱就診)人次共13,485,473人次,處方13,592,495張,已調劑處方13,402,978張。 敘述性分析結果中,老年高診次族群平均年齡為74.7 ± 6.0歲;年就診人次、年就診醫療院所、年就診科別數以及年就診醫師等高診次行為相關變項中,老年高診次與非高診次族群平均分別為69.2 ± 20.7與17.6 | zh_TW |
dc.description.abstract | Background:
Frequent attenders (FAs) account for a relatively large proportion of ambulatory care visits. Studies on frequent attenders and prescription appropriateness of ambulatory cares have been reported. However, studies using the Taiwanese National Health Insurance Research Database (NHIRD) on prescription appropriateness were merely focused on medications prescribed within one single visit (visit-based). Concomitant medications (patient-oriented medication check-up) from different visits, physicians, or clinics/institutions were often ignored. Furthermore, many studies found most FAs were the elderly; yet, possible association between elderly FAs and prescription appropriateness has not been investigated. Objectives: The study aims to use the NHIRD to characterize elderly FAs as a population, to determine the ambulatory care prescription appropriateness of the elderly by patient-oriented approach, and to analyze the association between prescription appropriateness and FAs, as well as the association between prescription appropriateness and clinical outcomes. Methods: Data source of people aged > = 65 years in 2002 | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T06:03:22Z (GMT). No. of bitstreams: 1 ntu-99-R97451005-1.pdf: 1478215 bytes, checksum: cfd3b5ff36cecc0a7776c3639123fa83 (MD5) Previous issue date: 2010 | en |
dc.description.tableofcontents | 致謝 i
中文摘要 ii Abstract v 目 錄 viii 圖目錄 ix 表目錄 x 第一章 緒論 1 第一節 研究背景 1 第二節 研究目的 2 第二章 文獻探討 3 第一節 門診高診次族群之研究 3 第二節 老年人用藥相關問題 11 第三節 全民健康保險研究資料庫 24 第三章 研究方法 27 第一節 研究材料 27 第二節 定義說明 31 第三節 研究架構 38 第四節 自變項說明 39 第五節 作業軟體與統計分析 47 第四章 研究結果 51 第一節 基本資料 51 第二節 老年高診次族群之敘述性分析(第一階段) 58 第三節 探討老年高診次族群之相關因子(第二階段) 68 第四節 老年門診處方適當性之研究(第三階段) 74 第五節 臨床結果(第四階段) 101 第五章 討論 121 第一節 研究特色 121 第二節 老年高診次族群 123 第三節 老年門診處方適當性評估 126 第四節 研究限制 133 第六章 結論 136 參考文獻 137 附錄 143 | |
dc.language.iso | zh-TW | |
dc.title | 全民健康保險研究資料庫老年門診處方探討:高診次與處方適當性之分析 | zh_TW |
dc.title | Ambulatory Care Prescriptions for the Elderly: Analyses of Frequent Attenders and Prescription Appropriateness Using National Health Insurance Research Database | en |
dc.type | Thesis | |
dc.date.schoolyear | 98-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 陳瓊雪,嚴崇仁,朱蓁蓁,于明暉 | |
dc.subject.keyword | 處方適當性,高診次族群,老年人,臺灣,全民健康保險研究資料庫, | zh_TW |
dc.subject.keyword | prescription appropriateness,frequent attender,elderly people,Taiwan,National health insurance research database, | en |
dc.relation.page | 165 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2010-08-16 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床藥學研究所 | zh_TW |
顯示於系所單位: | 臨床藥學研究所 |
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