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    题名: The factors associated with frequent utilizations of high-tech medical equipment -the case of computed tomography
    作者: pei-lien Lin
    贡献者: Department of Healthcare Administration/Healthcare Division
    关键词: frequent utilizations;computed tomography;high-tech medical utilization
    日期: 2006
    上传时间: 2009-11-17 19:12:19 (UTC+8)
    出版者: Asia University
    摘要: Objectives: High-tech medical instruments are one of the main factors for the rise of health care cost. According to relevant researches in Taiwan, our residents have some common problems in medical utilizations which are cross-region, cross-hospital accreditation and the frequent utilizations medical. Therefore this study analyzed the frequent user for CT (computed tomography) to explore the associated factors with the frequent utilizations of high-tech medical equipment.
    Methods: This study used the sampling dataset which represents all insured patients in Taiwan. This dataset is annually published by National Health Research Institutes. This study employed CT claim data for the years 1997 to 2004. The samples of this study were the patient who had CT services in four observation period by 14days, 30days, 60days, and 90days. This study analyzed the medical utilization of those frequent users of CT. Furthermore the study used the logistic regression analysis to determine the associate factors with frequent utilizations of CT.
    Results: The important results of this study are:
    (1)Males had higher frequent utilization rate, and females had higher frequent utilization growth rate than males in four kind of observation period.
    (2)In three kinds of observation period by 30days, 60days, 90days, the multi-frequent utilization of CT grew with age.
    (3)Neurosurgery department had the highest frequent utilization rate of CT. For the annual growth rate of frequent utilization, Rehabilitation department is the highest.
    (4)Base on the hospital degree, the patients in medical center had highest frequent utilization growth rate. Base one the hospital ownership, the patients in foundational hospitals had higher frequent utilization rate than private and public hospitals.
    (5)On the type of disease, the reason of ?neoplasm?, ?genitourinary system?, and ?injury and poisoning? had higher reiterative utilization rate of CT.
    (6)The behavior that patients seek for medical services belonged to only inpatient services, comprehend outpatients and inpatient services had higher frequent utilization rate on CT than patients only with outpatient services.
    (7)On the medical behavior, inpatient services and the services comprehend outpatient and inpatient had the higher frequent utilization rate of CT than outpatient services.
    (8)CT?s density had a significant influence on CT frequent utilization after controlling for other factors.
    (9)In three observation period by 30days, 60days, and 90days, hospital physicians had a significant influence on CT frequent utilization.
    Conclusion: When the medicine resources sufficient in a region, the frequency of CT utilization will increase. The reasons for increasing utilization are the needs for the health status, the quality of radiography are unacceptable, or in order to shorten the return time of the investment costs for high-tech medical equipments. According to the results, this study proposes the following recommendations: 1.Confirming the high-tech medical utilization; 2.Monitoring the quality of high-tech medical equipment periodically.
    显示于类别:[健康管理組] 博碩士論文


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