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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81197完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 林先和(Hsien-Ho Lin) | |
| dc.contributor.author | Chia-Chi Huang | en |
| dc.contributor.author | 黃佳琪 | zh_TW |
| dc.date.accessioned | 2022-11-24T03:35:40Z | - |
| dc.date.available | 2021-08-30 | |
| dc.date.available | 2022-11-24T03:35:40Z | - |
| dc.date.copyright | 2021-08-30 | |
| dc.date.issued | 2021 | |
| dc.date.submitted | 2021-08-09 | |
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Cost-effectiveness of rehabilitation after an acute coronary event: a randomised controlled trial. The Medical journal of Australia, 183(9), 450–455. https://doi.org/10.5694/j.1326-5377.2005.tb07121.x. Accessed May 26th, 2021. 77. Leggett, L. E., Hauer, T., Martin, B. J., Manns, B., Aggarwal, S., Arena, R., Austford, L. D., Meldrum, D., Ghali, W., Knudtson, M. L., Norris, C. M., Stone, J. A., Clement, F. (2015). Optimizing Value From Cardiac Rehabilitation: A Cost-Utility Analysis Comparing Age, Sex, and Clinical Subgroups. Mayo Clinic proceedings, 90(8), 1011–1020. https://doi.org/10.1016/j.mayocp.2015.05.015. Accessed May 26th, 2021. 78. Griffin, S. C., Barber, J. A., Manca, A., Sculpher, M. J., Thompson, S. G., Buxton, M. J., Hemingway, H. (2007). Cost effectiveness of clinically appropriate decisions on alternative treatments for angina pectoris: prospective observational study. BMJ (Clinical research ed.), 334(7594), 624. https://doi.org/10.1136/bmj.39129.442164.55. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81197 | - |
| dc.description.abstract | "【研究目的】根據衛福部統計，109年國人十大死因，心臟疾病蟬聯第二，缺血性心臟疾病在臺灣所造成之疾病負擔有隨年增加的趨勢。儘管心臟復健具成本效益已被廣泛證實，然而尚需要考量各國之不同醫療體系並謹慎應用，因此本研究以健保署觀點探討對於急性冠心症門診心臟復健介入之成本效用分析。【研究方法】本研究採類實驗性研究，以方便取樣，並採意圖治療群體分析，於北醫附醫納入2020年7月15日至2021年4月14日被診斷為首次急性冠心症，並接受血管再灌流處置者為對象，依其意願分派為實驗組，接受為期8~12週心臟復健訓練，或對照組，維持原有術後相關衛生教育，於8~12週再進行後測，使用健康生活品質測量問卷（EuroQol instrument, EQ-5D）評量門診心臟復健介入對於冠心症患者術後生活品質的影響，並調查是否發生因主診斷為急性心肌梗塞或其他重大心血管事件而再住院以及門診心臟復健健保給付總額。【研究結果】接受為期8~12週門診心臟復健訓練後，EQ5D分數、效用值、健康狀況自我評量皆上升，與一般常規照護組於統計上皆達顯著差異；Log-Rank test顯示為期8~12週門診心臟復健訓練介入與否，與出院後非計畫性再住院之存活情形於統計上達顯著差異（P=0.036），經由Cox proportional hazard model比例風險模式分析，心臟復健介入相對於常規照護，能下降非計畫性再住院風險；心臟復健介入對於急性冠心症的患者，每上升1單位生活品質調整生命年數（QALY），健保需支付約386,433點（約新臺幣367,112元），小於臺灣國人支付意願之1~3倍國內生產毛額（2020年1 GDP=新臺幣838,541元），顯示心臟復健介入是符合經濟效益的選擇。【結論與建議】急性冠心症患者接受血管再灌流處置出院後，轉介門診心臟復健是具成本效用優勢的，臺灣統計數據顯示病患出院後轉介參與門診心臟復健比率低，期待能以適當獎勵患者參與、居家復健以及遠距醫療來提升後續心臟復健的參與率，以符合成本考量與經濟效益，使醫療資源能夠更合理有效地運用。" | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-24T03:35:40Z (GMT). No. of bitstreams: 1 U0001-0208202122315300.pdf: 1925262 bytes, checksum: a56a65e556a3c8bdaa1e4b43682cc243 (MD5) Previous issue date: 2021 | en |
| dc.description.tableofcontents | 口試委員會審定書 P.1 誌謝 P.2 中文摘要 P.3 英文摘要 P.4 目錄 P.5-6 圖/表目錄 P.7 第一章、導論 第一節、實習單位特色與簡介 P.8 第二節、研究背景與動機 P.9 第三節、研究目的與實習預期貢獻 P.10 第四節、名詞解釋 P.11-12 第二章、文獻回顧 第一節、急性心肌梗塞流行病學 P.13-15 第二節、心臟復健臨床療效分析 P.16-17 第三節、心臟復健成本效益分析 P.18-19 第三章、研究方法 第一節、研究設計與樣本 P.20-21 第二節、研究架構與假說 P.22-23 第三節、研究測量工具 P.24-26 第四節、統計方法 P.27 第四章、研究結果 第一節、研究樣本之描述性統計 P.28 第二節、心肌梗塞個案有無接受心臟復健之出院後非計畫性再住院調查 P.29-30 第三節、心肌梗塞個案有無接受心臟復健之健康生活品質測量問卷調查 P.31-32 第四節、心肌梗塞個案有無接受心臟復健之成本效用分析 P.33-35 第五章、討論與結論 第一節、研究目的與實習預期貢獻討論 P.36-38 第二節、研究限制及未來研究發展方向 P.39 第三節、結論與實務實習單位的回饋 P.40 第四節、相關政策上的意涵或政策建議 P.41 參考文獻 P.42-56 附錄 附錄一 人體試驗委員會通過證明書 P.57 附錄二 生活品質相關問卷EQ-5D-3L同意使用證明 P.58 附錄三 生活品質相關問卷EQ-5D-3L P.59-61 | |
| dc.language.iso | zh-TW | |
| dc.subject | 存活分析 | zh_TW |
| dc.subject | 成本效用分析 | zh_TW |
| dc.subject | 門診心臟復健 | zh_TW |
| dc.subject | 生活品質量表EQ5D | zh_TW |
| dc.subject | Survival analysis | en |
| dc.subject | Cost utility analysis | en |
| dc.subject | EuroQol instrument | en |
| dc.subject | Outpatient cardiac rehabilitation | en |
| dc.subject | EQ5D | en |
| dc.title | 探討急性冠心症門診心臟復健介入之成本效用分析 | zh_TW |
| dc.title | The Cost Utility of Outpatient Department Cardiac Rehabilitation in Acute Coronary Syndrome | en |
| dc.date.schoolyear | 109-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.advisor-orcid | 林先和(0000-0002-7481-6016) | |
| dc.contributor.oralexamcommittee | 康峻宏(Hsin-Tsai Liu),楊銘欽(Chih-Yang Tseng) | |
| dc.subject.keyword | 門診心臟復健,生活品質量表EQ5D,存活分析,成本效用分析, | zh_TW |
| dc.subject.keyword | Outpatient cardiac rehabilitation,EuroQol instrument, EQ5D,Survival analysis,Cost utility analysis, | en |
| dc.relation.page | 61 | |
| dc.identifier.doi | 10.6342/NTU202102012 | |
| dc.rights.note | 同意授權(限校園內公開) | |
| dc.date.accepted | 2021-08-10 | |
| 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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| U0001-0208202122315300.pdf 授權僅限NTU校內IP使用（校園外請利用VPN校外連線服務） | 1.88 MB | Adobe PDF |
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