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標題: 預測白內障手術患者自費人工水晶體之選擇
An Investigation on the Predicting Model of Self-paid Cataract Surgery Choice
作者: 曹中傑
Tsao, Chung-Chieh
Contributors: 林金賢
Chin-Shien Lin
高階經理人碩士在職專班
關鍵字: 自費人工水晶體;自費醫療;醫療品質;邏輯斯迴歸
self-pay IOL;self-pay treatment;quality of care;logistic regression model
日期: 2013
Issue Date: 2013-11-18 14:49:28 (UTC+8)
Publisher: 高階經理人碩士在職專班
摘要: 健保財政的困難與醫療科技的進步,使得自費醫療蓬勃發展,白內障手術為70歲以上老年人口最常見的手術之一,特殊功能水晶體以新的技術,改善人工水晶體之設計,健保局同意採差額給付。這造成了白內障手術同時具有健保醫療與自費醫療的雙重身分。
本研究的主要目的是以邏輯斯迴歸為方法,以研究者本身所服務之診所病人為研究對象,希望以適當之自變項預測出患者選擇自費人工水晶體之機率。
在五類自變項構面中,有七個變項以卡方檢定具顯著水準,分別為年齡、教育、職業、介紹人、健檢、保險、旅遊。進一步將此七項配置邏輯斯迴歸,結果發現介紹人變項、保險變項、年齡變項為影響自費人工水晶體選擇之主要原因。本研究亦發現自費人工水晶體的選擇與否,並不影響患者的滿意度。
然而利用本研究的迴歸模型,適當的提升預測白內障手術患者接受自費人工水晶體的機率,希望在病患確定要接受白內障手術的時候,就能夠接收到最適合他的衛教訊息,消除其疑慮,進而提昇本診所的醫療服務與醫療品質。
The financial difficulities of National Health Insurance(NHI) and the advances in medical technology make the booming expance of self-pay treatment.Cataract surgery is the most common surgical procedure in patients over 70 years old.Because of the new technologies to improve the design of IOL, bureau of NHI agreed to adopt the balance payment. It makes the dual identity of Cataract surgery-both of NHI treatment and self-pay treatment.
The purpose of this study is to predict the expenditure behavior of patients underwent cataract surgery. By using logistic regression models,we study the patients of our own clinics.
The results showed that among the five dimensions, we found 7 independent variables with a significance Chi-square test level. They are age, education, profession, referral, physical examination, insurance and tourism. Age, insurance and referral as the main reasons affecting the patients’choice of IOL when we use logistic regression models. Accuracy of this study is statistically significant.
We showed that the expenditure behavior of patients and the satisfaction of patients are not correlated.We hope patients can receive appropriate health information when he is going to operation.By using our models,we can improve the predictional rate.Reassurance and enhancement of clinic’s medical services and quality of care are our main goals.
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