長期照護機構中藥物治療問題之經濟影響評估
中文摘要
台灣地區自公元 1994 年以後即進入高齡化社會，人口老化引發了新的醫療問 題，大幅度增加了慢性病醫療以及長期照護的需求。
1980 年代以來，醫療健保費用節節上漲已成為世界健康照護制度均共同面臨 的困難，因而如何有效管控費用已為各國健康照護制度改革的重要課題。
本研究以回溯性方式，檢閱 44 位養護中心住民在某區域教學醫院的一年內病 歷記錄，探討養護中心住民醫療資源使用情況及耗費程度，並進一步了解與 討論藥物治療問題所產生的經濟衝擊。
住民平均年齡為 75.6 歲，平均罹患 3.4 種疾病，平均使用 4.8 種藥物。一年的 藥物使用中， 73.7% 的 65 歲以上住民曾接受至少一種不適合老年人的藥物治 療， 27.3% 的收入住民產生 25 件藥物治療問題。
本研究發現，養護機構中的住民由固定的醫師負責其醫療照護下，每人一年 的平均門診次數僅達 14.6 次。再以 65 歲以上住民和全國 65 歲以上老人比較，一年每人平均減少 10.4 次門診，而有 10,140 元的醫療花費差異。而在醫療 照護品質方面，本研究發現在 44 位住民在一年內，因藥物治療問題而造成的 醫療花費，佔所有住民一年醫療花費的百分之十一點一。
現今醫療支出節節高升，對於醫療資源的使用實需要更謹慎合理。希望能藉 此加強相關健康照護人員對於長期照護機構住民藥物治療的進一步探討。Economic Impact of Drug Related Problems in Long Term Care Facilities
英文摘要
Taiwan has been an “aging society” since 1994.Aging of population bring new medical proble ms, raising the requirement of chronic disease treatment and long term care substantially. Rais ing medical insurance cost has become a problem in every health care system since 1980,so it become an important issue to manage the cost in the world.
In this retrospective study, we reviewed 44 residents’ medical charts in a metropolitan hospital to realize the degree of the medical insurance cost consumed by the residents, and the economi c impact of drug related problems due to residents’ drug therapy.
Residents in average was 75.6 years old, taking 4.8 medications with 3.4 disease. In one year, 73.7% of residents elder than 65 years old received as least one inappropriate drug for elderly, and 27.3% of total 44 resident suffered drug related problems. We found 14.6 outpatient servi ces used per resident in one year when their medical care is taken by a family physician. Com paring with people elder than 65 years old in Taiwan, the outpatient service uses were reduced by 10.4 times, and cost reduced by NT 10,140 dollars. However, the cost induced by drug rela ted problems is up to 11.1% of the medical insurance cost consumed by all the residents in one year.
To use medical resources rationally is very important today, we hope the result of this study co uld call attention to the drug therapy of residents in long term care facilities for all the health c are provider.
