To Evaluate Medical Resource Utilization and Medical Outcome among Nurse with Cancers: A Long-term Longitudinal Study
| Autor: | Hsiao-Fen Chen, 陳小芬 |
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| Rok vydání: | 2018 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 106 Research purposes Currently, most researches on the health issues of nursing staff focuses on their work pressure, working shifts, work environment and cancer risk. However, there is a lack of researches on the relevant characteristics of nursing staff with cancers, and there is also a lack of researches on the medical resource consumption and medical efficacy of nursing staff with cancer. Therefore, the purpose of this study, conducted with the analysis of long-term data from large health insurance databases, is to explore the long-term characteristics of nursing staff with cancers, the differences in the medical resource consumption and medical efficacy, and other important factors. Research method This study aimed at nursing staff with cancers as research objects, adopting retrospective longitudinal research design. The data were obtained from the Longitudinal Health Insurance Database (LHID 1997 to 2013) of Taiwan National Health Insurance Research Database, linked with the medical expenses of the outpatients and the inpatients. In order to reduce the selection bias of the control samples, the demographic characteristics, clinical characteristics and institutional characteristics were used as benchmarks while Propensity Score Matching (PSM) of 1:8 between nurses with cancers and ordinary people was conducted. Chi-Square Trend Analysis was adopted to assess the long-term trend of personal characteristics of nursing staff with cancers, clinical characteristics, and institutional characteristics while Linear Regression Analysis and Cox survival analysis were adopted to explore the trend and change between the nursing staff''s medical resource consumption and medical efficacy during the study period, as well as other important factors. Research result 434 nursing staff with cancers and 3,472 ordinary people were analyzed in this study. During the study period, the age of the nursing staff with cancers was increasing, and the change in the age range of developing cancers increased the most (ES=1.02). The cancer incidence rate among nurses was 0.29 times as high as that of the ordinary people (95% CI = 0.27 to 0.32), indicating that cancer risk was significantly lower. In terms of the medical resource consumption, there was no significant difference between the nursing staff with cancers and the ordinary people (p=0.641), but the total medical expenses of the nursing staff with cancers was significantly higher than that of the general population by NTD$ 305,024 one year before the death. In terms of medical efficacy, there was no significant difference in cancer recurrence rate and mortality rate between the two groups (p=0.615). Conclusion and suggestion This study concluded that the nurses have a significantly lower cancer risk than the ordinary people, and there was no significant difference in the medical resource consumption or the medical efficacy after developing cancers. In other words, the nursing staff is more aware of health care than the ordinary people. However, the nursing staff, even with high degree of medical knowledge, may not overuse the medical resources or receive medical treatments for cancers earlier. It is recommended that the nursing staff with medical expertise should pay more attention to physical and mental health of their own. When diagnosed with cancers in early stage, the nursing staff should actively receive medical treatment or medical preventions to improve life quality. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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