Utilization patterns of Chinese medicine and Western medicine under the National Health Insurance Program in Taiwan, a population-based study from 1997 to 2003.
Utilization patterns of Chinese medicine and Western medicine under the National Health Insurance Program in Taiwan, a population-based study from 1997 to 2003.
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DOI：
10.1186/1472-6963-8-170
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发表时间：
2008-08-09
影响因子：
2.8
通讯作者：
Huang YT
中科院分区：
文献类型：
--
作者：
Chang LC;Huang N;Chou YJ;Lee CH;Kao FY;Huang YT
1995年，台湾启动了全民健康保险计划(National Health Insurance Program，NHI)，涵盖了西药和中药的使用。这项以人群为基础的研究旨在通过确定中医和西医的使用模式，了解中医在这一双重医疗体系中的作用，并分析影响选择医疗服务的人口统计特征和主要适应症，以制定策略，加强适当使用和减少不必要的中医使用。本研究使用1997年至2003年包含综合利用和登记信息的NHI样本文件，随机抽取1995年至2000年所有参保者中的200432名NHI受益人。本研究共纳入136,720名具有有效及完整注册及使用资料的受试者。采用Logistic回归方法估计中西医结合使用的优势比(OR)。对CM和WM的使用情况、服务频率和主要适应症进行评估。选择α=0.0 5的显著性水平。从1997年到2003年，与西医相比，CM的发病几率有所增加。女性使用中药(OR=1.48；95%CI：1.45~1.50；P<；0.001)和西药(OR=1.74；95%CI：1.72~1.77；P<；0.001)的几率较高，其中45~54岁组(OR=1.75；95%CI：1.68~1.82；P<；0.001)和西药(OR=1.09；95%CI：1.05~1.13；老年受试者(≥65岁)P<；0.001)。在所有收入群体中，CM和WM的几率相似。而中区(OR=1.65；95%CI：1.56~1.74；p<；0.001)和南部(OR=1.18；95%CI：1.12~1.25；p<；0.001)较高，偏远地区较低(OR=0.57；95%CI：0.52~0.63；p<；0.001)。大部分病人每年都会接受一次这两项医疗服务的门诊服务。然而，WM的利用率高于CM。超过90%的中医服务由诊所提供，而超过60%的西医服务由医院提供。呼吸系统疾病是中西医结合最常见的主要指征。中药是CM最常用的治疗形式(68.4-72.7%)。近年来，台湾地区中药的使用量呈上升趋势。这一增长趋势可能是由于CM在国家医疗保险体系中的覆盖。
In 1995, Taiwan has launched a national health-care system (the National Health Insurance Program, NHI) covering the use of both Western medicine (WM) and Chinese medicine (CM). This population-based study was conducted to understand the role of CM in this dual medical system by determining the utilization patterns of CM and WM and to analyze the demographic characteristics and primary indications influencing the choice of the medical services for the development of strategies to enhance the appropriate use and reduce unnecessary use of CM. This study used the NHI sample files from 1997 to 2003 consisting of comprehensive utilization and enrolment information for a random sample of 200,432 NHI beneficiaries of the total enrolees from 1995 to 2000. A total of 136,720 subjects with valid and complete enrolment and utilization data were included in this study. The logistic regression method was employed to estimate the odds ratios (ORs) for utilization of CM and WM. The usage, frequency of services, and primary indications for CM and WM were evaluated. A significance level of α = 0.05 was selected. Compared with WM, the odds of CM increased from 1997 to 2003. The odds of using CM (OR = 1.48; 95% CI: 1.45–1.50; p < 0.001) and WM (OR = 1.74; 95% CI: 1.72–1.77; p < 0.001) were higher in females and that of CM increased with age to a peak in the 45–54-year-group (OR = 1.75; 95% CI: 1.68–1.82; p < 0.001) and WM (OR = 1.09; 95% CI: 1.05–1.13; p < 0.001) in the elderly subjects (≥ 65 years). The odds of CM and WM were similar in all income groups. However, those of CM were higher in Central (OR = 1.65; 95% CI: 1.56–1.74; p < 0.001) and Southern Taiwan (OR = 1.18; 95% CI: 1.12–1.25; p < 0.001) and lower in the remote areas (OR = 0.57; 95% CI: 0.52–0.63; p < 0.001). Most of the patients had one ambulatory visit of both medical services annually. However, the utilization of WM predominated over CM. Over 90% of CM service was provided by clinics, whereas over 60% of WM service by hospitals. Diseases of the respiratory system was the most frequent primary indication in CM and WM. Herbal medication was the most commonly used form of CM (68.4–72.7%). In recent years, there is an increasing trend in the utilization of CM in Taiwan. This increasing trend may be due to the covering of CM in the national health insurance system.
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影响因子：
5.4
作者：
Chen, LW;Yang, WS;Yeh, CL
通讯作者：
Yeh, CL
影响因子：
5.4
作者：
Chi, CH;Lee, JL;Chen, SC
通讯作者：
Chen, SC
DOI：
10.1089/107555301300328142
发表时间：
2001-06-01
影响因子：
2.6
作者：
Cleary-Guida, MB;Okvat, HA;Ting, W
通讯作者：
Ting, W
影响因子：
158.5
作者：
EISENBERG, DM;KESSLER, RC;DELBANCO, TL
通讯作者：
DELBANCO, TL
影响因子：
2.6
作者：
Chen, Fang-Pey;Kung, Yen-Ying;Hwang, Shinn-Jang
通讯作者：
Hwang, Shinn-Jang