急性下背痛西醫醫療利用分析; An analysis of acute low back pain medical ulitilizatioin

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Title:	急性下背痛西醫醫療利用分析;An analysis of acute low back pain medical ulitilizatioin
Authors:	朱逸民
Contributors:	中國醫藥學院醫務管理研究所
Keywords:	急性下背痛;疾病管理;證據醫學;Low back pain;Disease management;Eviden based medicine
Date:	1990
Issue Date:	2009-12-03 09:20:56 (UTC+8)
Abstract:	下背部疼痛為現代工商社會常見疾病，其成因有許多，可分為功能性與解剖性兩類，許多往往是功能性之姿式不良，或肌肉拉傷。下背痛醫療利用佔健保之支出相當大金額（全民健康保險統計），下背痛於國內一般治療方式有衛教、藥物、復健、手術、中醫及民俗療法等方式。本研究為分析八十五年，八十六年，八十七年，三年健保西醫門診檔藥品及復健醫療有無改變。研究發現八十五年八十六年，八十七年，三年中（1）腰痛患者數量，逐步成長，（2）藥品及治療明細亦成長，（3）門診人次以科別分以骨科及復健科占大部分，（4）治療費用以基層診所及地區醫院為主。疾病管理為近年來於美國施行之整體醫療計劃以降低醫療費用，其多應用於老人，慢性病患者，其成員含醫療提供者，疾病管理者，資訊系統，臨床指引，專家系統，自我照顧系統，衛教，為治療流程之再造，初級治療者教育，醫療系統整合，保險人。臨床上已有許多計劃於不同之疾病，於不同之醫療保險系統推行，皆有其效果，多於慢性病照護。參考臨床指引，藥價基準之建立，實證醫學之應用，以提供臨床及管理上之參考，以降低醫療費用耗用。; Low back pain is a common disease in recent years. The etiology of low back pain has many factors, which may be classified as functional and organic. Most cases of low back pain result from incorrect postures or sprains. The cost of low back pain treatment is huge under National Health Insurance. Disease management is a complement management of disease, which includes prevention, treatment and continuous management of the whole disease. Participation management of disease involves clicians, case managers and health care organizations. The maladies covered in disease management include low back pain. The aim of this study is to analyze the cost of low back pain treatment. The data source comes from the 1997-99 National Health Insurance database. The study analyzes the cost of pharmacy and physical therapy through the 1997-1999 period. The result of the analysis shows that the cost of drug and rehabilitation increase from 1997 to 1999. Primary care and local hospital catch the most health care expenditure of low back pain patients. Disease management profile can decrease the cost of low back pain treatment, including the utilization of drug and physical therapy. Certain organizations have set up profiles or programs on disease management. AHCPR is one of them.
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