| Abstract: | 結核病(Tuberculosis, 簡稱TB)是向?是台灣公共衛生界一直關心的焦點問題之一。許多研究發現縱使各項措施?續實施，結核病之死亡?仍舊高居?下，一直維持在每十萬人口4 人左右，仍高出 WHO 定義之每十萬人口2 人之標準。因此，本研究希望瞭解影響台灣結核病病人及多重抗藥性肺結核病患死亡之相關因素。本研究共分為三?期，第一??用健保資?庫、死因檔及戶籍登記資?等，?用描述性統計、雙變項分析與?輯斯迴歸等方法，瞭解結核病病患死亡?、及影響死亡?之相關因素，?輯斯迴歸之依變項為結核病病患是否死亡，自變項包括病患特性、醫院特性與疾病特性等。第二??用健保資?庫(門診處方及治?明細檔、門診處方醫?明細檔、住院醫?費用清單明細檔、住院醫?費用醫?清單明細檔、醫事機構基本資?檔等)、死因檔及戶籍登記資?，?用統計分析與?輯斯回歸，瞭解台灣地區2001 ?至2006 ?多重抗藥性結核病病患死亡?、及影響死亡?之相關因素。第三?則?考?政院主計處統計地區標準分?，?用健保資?庫、死因檔、及戶籍登記資?等相關資?，進?統計分析與?輯斯回歸，瞭解台灣地區?市與偏遠地區肺結核及多重抗藥性肺結核病患死亡之相關影響因素。
Tuberculosis has been an important topic in public health controlling and preventing in Taiwan. The mortality rate for TB in Taiwan was around 3.5 per 100,000 population in year 2008, which is much higher than the WHO’s requirement which should be lower than 2 per 100,000 population. Many research concluded that the mortality rate for TB in Taiwan did not significant improved after several policies implemented. Therefore, the study is going to explore the risk factors for death in Tuberculosis in Taiwan. This is a three-year project. In the 1st year project, the study will focus on the new TB cases in year 2001 to 2006 in Taiwan. The study will use National Health Insurance Research Database (including Inpatient expenditures by admissions (DD), Ambulatory care expenditures by visits (CD), Registry for contracted medical facilities (HOSB), Registry for beneficiaries (ID)), death registry dataset, and household records to evaluate the trend of mortality rate for tuberculosis in Taiwan. Descriptive analysis, bivariate analysis and logistic regression analysis will be conducted to find the risk factors for death in TB in Taiwan for years 2001 to 2006. Logistic regression analyses will be performed to estimate the probability of death from treatment. The independent variables included in the analysis will be patients characteristics (gender, age, occupation, income, etc.), hospital characteristics, and disease characteristics (major disease, comorbidity index, default experience…etc.). In the 2nd year project, the study will focus on the new multi-drug resistant tuberculosis (MDR-TB). The study will use the same datasets as year one, but will add in dataset of Details of inpatient orders (DO) and Details of ambulatory care orders (OO) from National Health Insurance Research Database to understand the death trend forMDR-TB in Taiwan. Basic statistical analysis and logistic regression analysis will be conducted to explore the factors for death in MDR-TB in Taiwan, In the part of logistic regression, the dependent variable will be whether the MDR-TB patient dead or not, the independent variables will be patients’ characteristics (gender, age, occupation, income,etc.), hospital characteristics, and disease characteristics (major disease, comorbidity index, default experience…etc.). In the 3rd year project, the study will compare the difference of death for TB and MDR-TB in rural and urban areas. The study will conduct descriptive analysis and bivariate analysis to compare the death rate, length of stay for TB/ MDR-TB patients in rural areas and urban areas. In addition, the study will conduct logistic regression to find the related factors for TB/MDR-TB patient dead in Taiwan. Logistic regression analyses will be performed to estimate the probability of death from treatment. The independent variables included in the analysis will be patients’ characteristics (gender, age, occupation, income, living in rural/urban areas…etc.), hospital characteristics, and disease characteristics (major disease, comorbidity index, default experience…etc.). |
