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Rehabilitation Practice and Science

Translated Title

外傷性脊髓損傷者使用健保資源秏用率及復健之介入初探

Abstract

Spinal cord injury is associated with a substantial and long-term economic burden on both the patients and the national health insurance. Due to the advancements in medical techniques, the mortality rate of patients with spinal cord injury has decreased. Moreover, as the life expectancy has increased in Taiwan, patients with spinal cord injury may need long-term rehabilitation to restore their functions of daily living and prevent further complications. Nonetheless, long-term rehabilitation would increase the economic burden on the long-term care facilities, as expected. This study aimed to analyze the impact (from admission to 3-year follow-up after discharge) of medical expenses on patients with traumatic spinal cord injury, with a focus on using the medical resources more efficiently. In this study, data from the National Health Insurance Research Database was analyzed and 5,625 patients with traumatic spinal cord injury (ICD-9 classification cord 806.XX and 952.XX) between 2000 and 2009 (follow-up to 2012) were finally included. The extracted data included age, gender, cause of injury, duration of inpatient hospital stay, presence of other traumatic injuries, duration of rehabilitation, total number and duration of readmissions, and other variables that might have an impact on the medical expenses. Multiple regression analysis was performed to ascertain the effects of the variables. The results showed that the average hospitalization expenses were 96,246 ± 142,451 dollars, and the average duration of the inpatient hospital stay was 10.4 ± 25.3 days. In addition, the variables, that had a significant impact on the utilization of the health insurance included age, gender, site of injury, presence of other traumatic injuries, and the number of readmissions during the 3-year follow-up period. The results showed that patients using more health insurance and economic resources had some specific characteristics, including male aging from 40 to 60, cervical spinal cord injury, and receiving rehabilitation. Female aging more than 60 were more likely to suffer from traumatic spinal cord injury (TSCI) causing by accidents. Moreover, head injury was the commonest traumatic injuries combining with TSCI (14.9%). Only 17.1% and 5.6% patients with TSCI received inpatient rehabilitation and occupational therapy, respectively.

Language

Traditional Chinese

First Page

173

Last Page

182

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