Population-Based Cohort Study on the Risk of Cancer and Percancerous Medical Utilization in Children with Rheumatic Disease
| Autor: | Tung-Wei Lin, 林佟威 |
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| Rok vydání: | 2016 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 104 Objective: Chronic inflammation is the clinical manifestations of pediatric rheumatic disease and can increase the risk of cancer. The study is to investigate the risk of cancer and percancerous medical utilization in children with rheumatic disease. method: The design of this study is retrospective study with secondary data analysis. The sources of the data were drawn from National Health Insurance Research Database from 2000 to 2012 years. Patients under age eighteen and with a diagnosis of pediatric rheumatic disease, including systemic lupus erythematosus, juvenile idiopathic arthritis, Sjögren''s syndrome, Scleroderma, Polymyositis, Dermatomyositis, Vasculitis and Behçet''s disease. 1,741 participants were observed. Gender and age quadruple pairing were adopted in control group. Risk of cancer was analyzed by Cox Models; T test used to see the differences of medical utilization a year before acquiring cancer. Results: The ratio of the risk of cancer of pediatric rheumatic patients to the risk of cancer of non-pediatric rheumatic patients is 5.87 to 1; specifically, systemic lupus erythematosus(5.66), juvenile idiopathic arthritis(9.49), Sjögren''s syndrome(9.64), and Vasculitis(4.9). Regarding drug utilization, the risk of cancer for those who used immunoregulatory drugs increases 5.65 times; while for those who used biologics, the risk of cancer increases 26.01 times. Comparing pediatric rheumatic patients, their medical utilization a year prior to cancer with their history of medical utilization before cancer, they found that number of outpatients visits and medical cost are on the increase, but a decrease in hospitalization numbers, days and cost. No significant differences were found by the T test. Conclusions and Recommendations: It is recommended that Ministry of Health and Welfare and health department of local city governments should put more efforts on the medical care of pediatric rheumatic patients to reduce social cost in the future. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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