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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 蘇喜(Syi Su) | |
| dc.contributor.author | Teck-Jin Yang | en |
| dc.contributor.author | 楊德仁 | zh_TW |
| dc.date.accessioned | 2021-06-16T16:12:44Z | - |
| dc.date.available | 2018-03-04 | |
| dc.date.copyright | 2013-03-04 | |
| dc.date.issued | 2013 | |
| dc.date.submitted | 2013-02-18 | |
| dc.identifier.citation | 一、中文部份
中央健康保險局(2012，7月27日)。衛生署健保局提供B型及C型肝炎病患完整追蹤及治療，已獲初步成效。2012年1月1日取自http://www.nhi.gov.tw/PDA/NewsDetail.aspx?No=1017 中華民國統計資訊網(2012，3月)。97年肝相關疾病就診率性別統計分析。 2013年1月1日取自中華民國統計資訊網首頁 > 主計總處統計專區 > 性別統計專區 > 統計分析 >各部會性別議題相關之統計分析 > 衛生署 97年肝相關疾病就診率性別統計分析。 http://www.stat.gov.tw/ct.asp?xItem=27819&ctNode=531 王昶閔(2007，3月20日)。全國肝炎盛行率大調查�Ｂ肝帶原306萬人 Ｃ肝感染42萬人。2013年1月1日取自http://www.libertytimes.com.tw/2007/new/mar/20/today-life1.htm 行政院衛生署(2012，12月22日) 急診主要疾病就診率統計-按性別及年齡別分 。2013年1月1日取自行政院衛生署首頁＞查詢服務＞統計公布欄 ＞衛生統計系列(四)全民健康保險醫療統計 ＞100年度全民健康保險醫療統計年報 ＞八、急診主要疾病就診率統計-按性別及年齡別分 ＞http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=12495&class_no=440&level_no=3 行政院衛生署(2012，12月22日) 住院主要疾病就診率統計-按性別及年齡別分 。2013年1月1日取自行政院衛生署首頁＞查詢服務＞統計公布欄 ＞衛生統計系列(四)全民健康保險醫療統計 ＞100年度全民健康保險醫療統計年報 ＞六、住院主要疾病就診率統計-按性別及年齡別分 ＞ http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=12493&class_no=440&level_no=3 行政院衛生署(2012，5月25日) 100年國人主要死因統計(以ICD-10編碼)。2013年1月1日取自http://www.doh.gov.tw/CHT2006/DM/DM2_p01.aspx?class_no=25&level_no=1&doc_no=84788 肝炎研究中心(2013，1月1日)。肝炎的介紹。2013年1月1日取自http://www.ntuh.gov.tw/HRC/Hepatitis/default.aspx 柯萬盛、郭志宏(2009)。冬蟲夏草複方輔助治療慢性C型肝炎之血中硒含量及氧化壓力之研究。光田醫學雜誌, 4(7), 7-14. 徐慈穗(2011)。病人用藥教育淺談慢性B型肝炎用藥治療（上）。藥師週刊電子報，1723 財團法人肝病防治學術基金會(2013，1月1日)。肝病常識分類查詢。2013年1月1日取自http://www.liver.org.tw/index.php?option=com_content&view=article&layout=liverarticle&id=262 張鴻仁、黃信忠、蔣翠蘋(2002)。全民健保醫療利用集中狀況及高、低使用者特性之探討。台灣衛誌、21(3)，207-213 陳誼芬(2008)。B型肝炎患者就醫型態及醫療耗用之分析。長庚大學企業管理研究所碩士論文，未出版，桃園。 楊世仰、許麗卿(2004)。臺灣地區十五歲以上年齡層C型肝炎盛行率及基因型別研究。衛生學，行政院衛生署疾病管制局。 廖運範(2007)。HBeAg陰性的慢性B型肝炎。當代醫學，34(7)，515-521。 衛生署疾病管制局(2013，1月1日)。急性病毒性Ｂ型肝炎。2013年1月1日取自http://www.cdc.gov.tw/professional/diseaseinfo.aspx?treeid=82CE806A312CEFEC&nowtreeid=F0FD5A55BBB6C41A&tid=5CA41646EE28F677#3 衛生署疾病管制局(2013，1月1日)。急性病毒性C型肝炎。2013年1月1日取自http://www.cdc.gov.tw/professional/ThemaNet.aspx?treeid=beac9c103df952c4&nowtreeid=AC81BE2A11A0FCEF&did=657 鄭人慈、蕭淑珍、江吉文、戴慶玲(2008)。Silymarin於肝臟疾病之治療：臨床應用與實證結果。藥學雜誌，96，129-134 盧勝男(1998)。走過C型肝炎鄉。中華公共衛生雜誌，17(3)，175-187。 二、英文部份 Abad-Lacruz, A., Cabre, E., Gonzalez-Huix, F. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/62859 | - |
| dc.description.abstract | 台灣Ｂ型肝炎帶原人數約三百零六萬人；而Ｃ型肝炎感染人數約四十二萬人，肝炎是台灣的國病, 國內外對於肝炎病患中的肝硬化及肝癌的預後預測研究不少, 但對於急性肝炎病患醫療資源耗用的預測研究卻不多。
目的：探討急診急性肝炎病患之病人特質及臨床特質與醫療資源耗用之相關性。 方法：以醫院資訊系統與病歷審閱收集研究資料進行回溯性研究，選取自2003年一月份至2007年六月份至台北市某家規模1000床教學醫急診就診的急性肝炎病患成為研究對象，分析病患特質(包含性別及年齡層)及病患的臨床特質(肝炎種類、Child-Pugh Score以及腹部超音波檢查結果)與醫療資源耗用(包含住院天數以及醫療費用)的相關性。 結果：研究期間該醫院急診共有急性肝炎發作病患124人就診，其中資料完整共117人次。經ANOVA分析，病患特質(包含性別及年齡層)、肝炎種類均和醫療資源耗用(包含住院天數以及醫療費用)沒有顯著的相關性。但是病患的臨床特質中，Child-Pugh Score與醫療資源耗用(包含住院天期以及醫療費用)有顯著相關性；腹部超音波檢查中脾臟腫大此一項目和住院天數有顯著相關係，而腹部超音波檢查中腹水此一項目和醫療費用中總申報點數有顯著相關性。 結論：Child-Pugh Score傳統上用來預測肝硬化及末期肝病病患的預後，而腹部超音波亦是常用來快速診斷及評估急性肝炎的工具，本篇研究發現Child-Pugh score和腹部超音波可以共同用來預測急診急性肝炎病患(排除肝硬化患者)的醫療資源耗用。 | zh_TW |
| dc.description.abstract | Taiwan is a hyperendemic area of Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population > 20 years old is 3,067,307 and 61% patients involved in this study are hepatitis B related.
A case record review was conducted from January 2003 to June 2007 of all patients admitted to the Emergency Department (ED) of one university hospital with diagnosis of acute hepatitis. The prognosis of liver cirrhosis is assessed by using Child-Pugh score. Since abdominal ultrasound is also a commonly used tool for the evaluation and rapid diagnosis of acute hepatitis in the ED, the objective of this study is to determine whether Child-Pugh score and abdominal ultrasound could be used simultaneously to predict the medical resource utilization in patients of acute hepatitis without liver cirrhosis in the ED. The characters, such as sex, age and type of hepatitis, of the patients were also analyzed. The medical resource utilization is defined as the length of hospital stay and the total medical fee. The statistic procedure, Analysis of variance (ANOVA), was adopted in the data analysis. A total of 117 patients met the inclusion criteria. The characters of the patients, such as sex, age and the type of hepatitis, have no significant differences of medical resource utilization. However, Child-Pugh score has significant differences of medical resource utilization on both the length of hospital stay and the total medical fee. Besides, the finding of abdominal ultrasound such as splenomegaly has significant difference on the length of hospital stay, and the finding of abdominal echo such as ascites has significant difference on the total medical fee. In conclusion, Child-Pugh score and abdominal ultrasound could be used simultaneously to predict the medical resource utilization in patients of acute hepatitis without liver cirrhosis in the ED. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-16T16:12:44Z (GMT). No. of bitstreams: 1 ntu-102-P98843003-1.pdf: 554754 bytes, checksum: 03cfc641f3bd6cb5002f257ac5ba9190 (MD5) Previous issue date: 2013 | en |
| dc.description.tableofcontents | 中文摘要 i
目錄 iv 圖目錄 vi 表目錄 vii 第一章 緒論 1 第一節 研究動機 1 第二節 研究目的 4 第三節 研究問題 4 第四節 研究流程 4 第五節 名詞解釋 6 第二章 文獻探討 7 第一節 肝炎介紹以及常規肝炎治療方式 7 第二節 肝炎病患之醫療耗用分析及就醫型態 15 第三節 肝炎相關預測因子探討 24 第四節 肝炎與另類療法 27 第五節 Child Score與相關醫療資源耗用介紹 31 第三章 研究方法 34 第一節 研究架構 34 第二節 研究假說 35 第三節 研究變項與操作型定義 36 第四節 研究對象與資料來源 39 第五節 資料分析方法 40 第四章 研究結果及討論 41 第一節 研究對象基本特性分析 41 第二節 影響醫療資源耗用因素之描述性分析 42 第三節 病患特質與醫療資源耗用之推論性分析 47 第四節 臨床特質與醫療資源耗用之推論性分析 52 第五章 結論與建議 61 第一節 研究總結 61 第二節 研究建議 65 第三節 研究限制及後續研究 66 參考文獻 67 一、中文部份 67 二、英文部份 70 | |
| dc.language.iso | zh-TW | |
| dc.title | 急診急性肝炎病患醫療資源耗用相關因素之研究 | zh_TW |
| dc.title | Medical Resource Utilization of Patients with Acute Hepatitis in Emergency Department | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 101-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.coadvisor | 郭人介(Ren-Jieh Kuo) | |
| dc.contributor.oralexamcommittee | 石崇良,張永源 | |
| dc.subject.keyword | 急性肝炎,醫療資源耗用,Child-Pugh score,腹部超音波, | zh_TW |
| dc.subject.keyword | acute hepatitis,medical resource utilization,Child-Pugh score,abdominal ultrasound, | en |
| dc.relation.page | 78 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2013-02-18 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 健康政策與管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
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