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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 陳為堅(Wei J. Chen) | |
| dc.contributor.author | Chih-Lin Chiang | en |
| dc.contributor.author | 江芝林 | zh_TW |
| dc.date.accessioned | 2021-06-16T06:43:33Z | - |
| dc.date.available | 2017-10-20 | |
| dc.date.copyright | 2014-10-20 | |
| dc.date.issued | 2014 | |
| dc.date.submitted | 2014-07-28 | |
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/57374 | - |
| dc.description.abstract | 研究目的：本研究欲分析台灣1998年至2007年全國之精神分裂症初次住院個案之特徵、趨勢及相關因子。
研究方法：利用全民健保研究資料庫之精神科住院歸人檔，研究者定義出全國55,172名於1998年至2007年間初次住院之精神分裂症個案，其住院主診斷均曾有ICD-9-CM 碼為 295.x 者。研究者除了計算個案於初次出院後30天內、1年及2年內之臨床指標之外，並以 multilevel regression model 矯正個案、醫院、醫師及治療層次之變數，以分析其相關因子。 結果：精神分裂症初次住院之發生率，由1998年的千分之0.253人年降低至2007年的千分之0.152人年，降幅達40%。初次住院天數隨著初次住院年份越近而顯著縮短。出院後之再住院率雖亦隨著初次住院年份越近而降低，但其下降幅度較低。出院後之藥物遵從度與初次住院年份之間，在矯正各項因子後則無顯著關係。於研究觀察期間，口服第二代抗精神病藥物成為初次住院最常使用之藥物治療，取代口服第一代抗精神病藥物，但第二代抗精神病藥物之普遍使用僅占住院治療費用成長之一小部分。若病患年齡越輕、合併有物質使用疾患、初次住院在地區醫院、住院中僅接受第一代抗精神病藥物治療，出院後之再住院率較高、且出院後藥物遵從度較低。 結論：本研究顯示，相較於接受第一代抗精神病藥物治療之患者，初次住院中接受第二代抗精神病藥物治療之患者出院後之藥物遵從度較高、且再住院率較低。歷年精神分裂症初次再住院率之降低趨勢，是否反應不同年代治療效果之進步，值得進一步探討。 | zh_TW |
| dc.description.provenance | Made available in DSpace on 2021-06-16T06:43:33Z (GMT). No. of bitstreams: 1 ntu-103-R01847020-1.pdf: 2693281 bytes, checksum: fe9807db28e29aa5fd662ff0511e1370 (MD5) Previous issue date: 2014 | en |
| dc.description.tableofcontents | 口試審定書 i
中文摘要 ii Abstract iii Chapter 1. Introduction 1 1.1 Practicum unit features and brief introduction 1 1.2 Background 1 1.3 Framework and hypotheses 3 1.4 Aims of Our Research 3 Chapter 2. Methods 4 2.1 Database 4 2.2 Study Population 4 2.3 Dependent variables 5 2.3.1 Service utilization during first admissions 5 2.3.2 Short-term outcomes after discharge 5 2.3.3 Long-term outcomes after discharge 5 2.4 Independent variables 6 2.5 Calculation and standardization of incidence and other binary outcomes 6 2.6 Statistical analysis 7 Chapter 3. Results 8 3.1 Demographic profiles of subjects and hospitals 8 3.2 Incidence of first admissions for schizophrenia 8 3.3 Psychiatric comorbidities of first admission for schizophrenia 9 3.4 Length of first hospitalization for schizophrenia 9 3.5 Biological treatment of first admission for schizophrenia 9 3.6 Medical costs of first admission for schizophrenia 10 3.7 Short-term outcomes after first admission for schizophrenia 10 3.8 Long-term outcomes after first admission for schizophrenia 10 3.9 Association between inpatient antipsychotic regimens and clinical outcomes 10 Chapter 4. Discussion 12 4.1 Summary of our major findings 12 4.2 Interpretation of these findings 13 4.3 Compare the result with previous studies analyzing NHIRD 15 4.3.1 Time trend of hospitalization 15 4.3.2 Time trend of medication compliance 16 4.3.3 Effects of SGA on re-hospitalization rates 16 4.3.4 Effects of SGA on medication compliance rate 16 4.4 Compare the result with previous studies in other countries 17 4.5 Strength and Limitation 18 Chapter 5. Conclusion 19 Chapter 6. Reference 20 | |
| dc.language.iso | zh-TW | |
| dc.subject | 大規模人群研究 | zh_TW |
| dc.subject | 年代趨勢 | zh_TW |
| dc.subject | 初次住院發生率 | zh_TW |
| dc.subject | 再住院率 | zh_TW |
| dc.subject | 藥物遵從度 | zh_TW |
| dc.subject | 第二代抗精神病藥物 | zh_TW |
| dc.subject | 精神分裂症 | zh_TW |
| dc.subject | schizophrenia | en |
| dc.subject | first-admission incidence | en |
| dc.subject | population-based study | en |
| dc.subject | secular trend | en |
| dc.subject | re-hospitalization | en |
| dc.subject | adherence | en |
| dc.subject | second-generation antipsychotic | en |
| dc.title | 初次住院之精神分裂症發生率：1998至2007年之全國性趨勢及其相關因子分析 | zh_TW |
| dc.title | Incidence of first admission for schizophrenia: national trend from 1998 to 2007 and its correlates | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 102-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 陳培君(Pei-Chun Chen),劉震鐘(Chen-Chung Liu),董鈺琪(Yu-Chi Tung) | |
| dc.subject.keyword | 精神分裂症,初次住院發生率,大規模人群研究,年代趨勢,再住院率,藥物遵從度,第二代抗精神病藥物, | zh_TW |
| dc.subject.keyword | schizophrenia,first-admission incidence,population-based study,secular trend,re-hospitalization,adherence,second-generation antipsychotic, | en |
| dc.relation.page | 46 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2014-07-29 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
| 顯示於系所單位： | 公共衛生碩士學位學程 | |
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