Medical Utilization and Seeking Behavior of Permanent Residents of Pingtung Country with Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention
| Autor: | Yi-Han Hung, 洪伊含 |
|---|---|
| Rok vydání: | 2010 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 98 The purpose of this study was to assess the medical treatment of the residents in Pingtung County who had Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI) and also to examine medical utilization one year before and after receiving surgery. The research indicated the factors and the influence levels of both medical quality and utilization. Retrospective secondary data analysis was employed in this study. The data included the residents having medical treatments between 2005 and 2007, and the main source was The Bureau of National Health Insurance – Kaoping Division. After data processing, there were 1140 records related to CABG and PCI. Results: In terms of medical seeking behavior, medical quality and medical utilization of PCI patients in different medical facilities, the only significant differences involved aboriginal identity and residence. There were also significant differences in first admission mortality and the hospitalization expenses of CABG patients. One year after surgery, the utility of outpatient services resources for PCI and CABG patients in different medical facilities was higher than one year before surgery. The total expense of the patients who received PCI in the county was lower (394,953) than the ones who received PCI out of the county (446,496). The total expense of the patients who received CABG in the county was higher (867,979) than the ones who received CABG out of the county (633,259). As for hospitalization quality, the PCI patients who were in the high-risk group of first admission mortality were over 65 years old and the scores of comorbidity were above 2. With regard to the utility of hospitalization resources, the length of stay was significantly increased among the PCI patients who were females, whose scores of comorbidity were above 2, who had complications in the first admission, or who died in the first admission. The expense was significantly increased among the PCI patients whose scores of comorbidity were above 2, who had complications in the first admission, or who died in the first admission. The length of stay was significantly increased among the CABG patients who were females, who had complications in the first admission, or who had medical treatments in private hospitals. The expense was significantly increased among the CABG patients who had complications in the first admission. Conclusion: The mortality of the first admission is higher in Pintung County than out of the county, so several suggestions are offered to health authorities. First of all, the cardiologists in the hospitals of Pintung County should be provided continuous education and subsidies for advanced study. In addition, the hospitals should be assisted with development in cardiology in order to decrease the differences of medical resources in and out of the county and increase people’s confidence in seeking doctors. Moreover, the hospitals in the county which provide cardiology treatment should establish features according to the resources in the hospitals. Finally, the hospitals in the county could also have strategic alliances with other nearby hospitals so that residents in Pintung County will have support for having complete treatments. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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