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博碩士論文 etd-0809116-104105 詳細資訊
Title page for etd-0809116-104105
論文名稱
Title
注意力不足過動症孩童在台灣健保制度下使用復健資源之探討
Survey of Rehabilitation Resources in Children with Attention Deficit Hyperactivity Disorder under National Health Insurance in Taiwan
系所名稱
Department
畢業學年期
Year, semester
語文別
Language
學位類別
Degree
頁數
Number of pages
62
研究生
Author
指導教授
Advisor
召集委員
Convenor
口試委員
Advisory Committee
口試日期
Date of Exam
2016-08-25
繳交日期
Date of Submission
2016-09-09
關鍵字
Keywords
台灣、注意力不足過動症、復健資源、全民健保、非藥物治療
non-drug treatment, Taiwan, Attention deficit hyperactivity disorder, Rehabilitation Resources, National Health Insurance
統計
Statistics
本論文已被瀏覽 5741 次,被下載 407
The thesis/dissertation has been browsed 5741 times, has been downloaded 407 times.
中文摘要
背景:
注意力不足過動症是一種兒童神經發展的疾患,研究目的為了解非藥物治療上復健治療的使用情形。
方法:
依據全民健康保險研究資料庫2008年到2012年的復健資料中,篩選出年齡3-12歲孩童做研究對象,再將孩童以ICD-9-CM的診斷分成注意力不足過動症及非注意力不足過動症兩大族群,探討兩者之間在復健資源使用上的差異,並找出相關因子。
結果:
使用卡方檢定、獨立樣本t檢定和多元迴歸分析,發現在接受復健資源的兒童當中,注意力不足過動症平均占18.5%,人數逐年上升,就診次數也是逐年上升,比非過動症來的高。男女比大約3:1(p<0.001)。學齡兒童比例比學齡前來的高(p<0.001)。復健資源的使用最多在基層診所,占60%(p<0.001)。非教學醫院占70%以上(p<0.001)。地區方面則是台北市的就診最高、東區最低(p<0.001)。不論是每年的平均費用、平均次數、年度總費用過動症都比非過動症來的高(p<0.001)。在預測過動症的資源使用上,平均費用、平均次數、年度總費用受到過動症與否、年度、人口學特質、醫院特性和地區等各項因素影響(p<0.001)。
結論:
過動症孩童日益增多,復健資源上的使用日益增加,健保點值仍偏低,且資源分配嚴重不均,值得訂定相關政策協助孩童,減輕家庭負擔和減少社會成本,值得關切。
Abstract
Background:
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder in children. The research goal is to understand the situation on the use of non-drug treatment rehabilitation treatment.
Method:
According to the National Health Insurance Research Database rehabilitation materials from 2008 to 2012, selected children aged 3-12 years would be included in the research objective, The children who are diagnosed by ICD-9-CM will be divided into two groups; attention deficit hyperactivity disorder and non-attention deficit hyperactivity disorder; to discuss the differences in the use of resources on rehabilitation, and find relevant facts.
Result:
Using chi-squared test, independent sample t test and multiple regression analysis, we found that children receiving rehabilitation resources diagnosed as attention deficit hyperactivity disorder are on average of 18.5%. The number of patients and the frequency are increasing year by year. The ADHD group compared to non-ADHD one is more, while the male to female ratio is 3: 1 (p <0.001). The proportion of school-age children with ADHD was identified as being higher than in preschool (p <0.001). The most use of rehabilitation resources is at clinics, accounting for 60% (p <0.001). Non-teaching hospitals accounted for more than 70% (p <0.001). Regional aspects of treatment are highest in Taipei, in contrast to Eastern which is the lowest (p <0.001). No matter whether it is the average cost per year, the average number of times or annual total cost, ADHD group is more than non-ADHD one (p <0.001). The prediction of rehabilitation resources usage on ADHD, the average cost, average frequency, the total annual cost are affected by factors such as whether ADHD has been diagnosed or not, timing of rehabilitation use, demographic characteristics, and speciality of hospitals and regions (p <0.001).

Conclusion:
The number of children with ADHD and the use of resources on rehabilitation is increasing, but health care point value is still low, and severe uneven distribution of resources is concerned. It will be worthwhile setting policies to assist children to reduce the family burden and the social costs in the future.
目次 Table of Contents
論文審定書 i
誌謝 ii
摘要 iii
ABSTRACT iv
目錄 vi
圖次 viii
表次 viii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 2
第二章 文獻探討 3
第一節 注意力不足過動症 3
第二節 流行病學及發生率 5
第三節 疾病成因 5
第四節 治療方法 6
第五節 資源使用情形 7
第三章 研究方法 11
第一節 研究架構 11
第二節 資料來源與研究樣本 11
第三節 研究變項 13
第四節 研究流程 14
第五節 資料處理及分析方法 16
第四章 研究分析與結果 17
第一節 描述性統計分析 17
第二節 推論性統計分析 26
第五章 綜合討論 42
第一節 討論 42
第二節 限制 46
第三節 結論 47
一、中文文獻 49
二、英文文獻 49
參考文獻 References
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