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運用健保資料庫建立台灣疾病盛行率之臨床決策支援系統

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運用健保資料庫建立台灣疾病盛行率之臨床決策支援系統

Establishment of clinical decision support system for prevalence of

diseases in Taiwan based on national health insurance research

database

中文摘要

疾病盛行率是公共衛生中基本的測量。不同年齡,不同地區,不同性別,不同時

間,不同族群都有不同之疾病盛行率。本研究是利用全民健保研究資料庫的完整

性,從全國門診診斷檔中,分析全國之疾病盛行率情形。

研究目的是利用健保資料庫的完整性,從二年的門診就醫記錄中,建置健保分析

處理資料倉儲系統,利用資料處理的流程,以關連式資料庫與資料探勘的方法,

從年約三億多人次門診診斷中,針對不同年齡、地區、性別、時間,進行所有門

診案件的多維度疾病盛行率分析,提供公共衛生,藥物費用估計及臨床診斷決策

支援之用。

研究結果發現,本決策系統使用者可以經由網際網路,以多維度的方式對疾病盛

行率做線上即時查詢,做交叉分析。系統正確性評估,使用者評估與大型流行病

學之比較均顯示本系統之可信性、可用性極高。

研究結論,隨著資訊科技的發展,健保制度的實施,電子化的申報資料,使得醫

學資料大量的累積。透過資訊科技的應用,將大量的資料轉變成資訊,進而變成

知識,已非遙不可及。

根據本研究初始目的,本系統目前的確可以對資料作相當程度的事實描述,並根

據這些描述來判斷推論,成為輔助決策之支援系統。因此我們可以利用此技術來

直接從健保龐大資料庫擷取有用的資訊,可以對於疾病的特性、分布,有更加的

了解,進而為人類健康福祉提供更好的保障。

英文摘要

Background: Disease prevalence is the basic measurement in public health and epidemiology. Many factors including sex, age , area, season and population have important impact on disease prevalence.

Objectives: The purpose of this study was to establish a decision support system for disease prevalence in a large claim database of ambulatory diagnosis in Taiwan. Methods: All diagnose data administered in 2000, 2001 were transferred to data warehouse. Then we establish On-Line Analysis Process (OLAP) by different cubes grouped by different disease category. After that, we construct user friendly interface to provide data analysis and to support decision making.

Results: By using this decision making support system, the users can view their interesting disease prevalence rate and frequencies of patients visiting by age, sex,

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area, and time.

Conclusions: The system is hightly reliable and usable after correctness evaluation, user evaluation and compare to large epidemiology study.

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