| 摘要: | 氣喘是一種慢性疾病，它會反覆發作，也可能自行緩解，而多數氣喘病患普遍缺乏正確知識，亦無良好的疾病管理方式，為提升氣喘病患自我照護能力及改善生活品質，全民健保局在2001年推動「全民健康保險氣喘醫療給付改善方案試辦計劃」又稱「論質計酬計畫」，結合了「論質計酬」與「疾病管理」的概念，以病患照護結果之成效為支付費用的依據。本研究目的為探討加入此計畫之氣喘病患選擇中西醫合併治療方式的影響因素、常使用方劑及中西醫合併治療與照護結果之相關。本研究為回溯性研究，以2001年至2003年加入計劃的氣喘病患為研究對象，分為接受中西醫合併治療與單純接受西醫治療兩組。以病患加入此計畫時的各項狀態作為基準，並以醫療使用率（門診、急診、住院）為其照護結果加以分析。本研究發現，氣喘嚴重度及性別皆會影響病患是否選擇中西醫合併治療。在照護結果上，兩組研究對象僅門診次數有顯著差異，但整體而言醫療使用率皆有下降之趨勢。在中藥常用方劑上，使用次數最多的為杏仁及定喘湯。
本研究之資料庫年數太短，且資料皆以西醫為主，建議後續相關研究能加長研究年數並以中醫資料庫為主，將更能真實呈現中醫對氣喘病患之影響。
Asthma is one kind of chronic disease, it breaks out repeatedly, but sometimes it may Self-mitigation. Most of the asthma patients lack for the knowledge of this disease, and they are also scanty of well management for it. In order to improve the ability of asthma patients to take care of themselves and their living quality, National Health Insurance sets The Improvement Program of National Health Insurance Payment for asthma Medical Treatment into action in 2001, or called pay for performance program. It combined the concept of pay for performance and disease management, so the amount of payment will base on the care results of the patients. The research is dedicated to find out the elements for encourage the asthma patients admitted in the program to choose the treatment of Chinese and Western Medicine, the common used Chinese Medicine, and the relationship between the treatment of Chinese and Western Medicine and the care result. The research is a retrospective study, the study objects is the patients admitted in the program during 2001 to 2003, which are divided into two groups. The patients of the first group are under the treatment of Chinese and Western Medicine, and the patients in another group are only under the treatment of Western Medicine. Base on the status of the patients when they just admitted to the program, and analyze the medical resource utilities as the care results which consist of outpatient, admissions, and emergency. The research found out that how serious of the asthma and the gender of the patients both effect the willing of the patients to choose the treatment of Chinese and Western Medicine. In the result of care, two of the study objects only show remarkable difference in the amount of outpatient, but both of their medical resource utilities have a decreasing trend. In the common used Chinese medicine, the almond and the Ding Chuan Tang is the mostly used medicine.
The database of the research only contains a few years of data, and those data are most related to Western medicine. We suggest that the following study may increase the time for the research and replenish more data of Chinese medicine, which would represent the influence of the Chinese medicine treatment to the asthma patients more clearly. |
