台灣地區2000年至2010年間上泌尿道結石及膀胱結石之醫療使用趨勢
胡哲源，黃國皓1
國立成功大學附設醫院 泌尿部，1國立台灣大學附設醫院 泌尿部
The Trend of Medical Cost for Upper Urinary Tract Stone and Bladder Stone disease in Taiwan, from 2000 to 2010
Che-Yuan Hu, Kuo-How Huang1
National Cheng Kung University Hospital, 1National Taiwan University Hospital
Purpose: To investigate the medical utilization and costs of urolithiasis in Taiwan using a nationwide population-based database.
Materials and Methods: This study is based on Taiwan's National Health Insurance Research Database (NHIRD), which contains the data of all medical beneficiary claims from 22.72 million enrollees. To assess the annual medical care visits for urolithiasis, we first identified all patients enrolled in NHIRD during the study period, 2000-2010 whose claims records included at least one diagnosis of urolithiasis. The medical cost of urolithiasis was calculated by claim records of all beneficiaries enrolled in NHIRD, including all diagnosis- and treatment-related costs at inpatient, emergency and ambulatory services associated with the diagnosis of urolithiasis.
Results: UUT stone disease consists of 97.9% of medical costs for stone disease. There were rising trends in the medical utilization and costs for UUT stone disease during the period by increasing 9.9% in medical care visits/100,000 subjects (r2=0.48; p=0.007) and by 31.1% increase in medical costs (r2=0.81; p=0.001). The peak age strata of medical care visits for UUT stone diseases in both genders were 60-69 years. For LUT stone disease, there is a declining trend in the medical utilization, but it is not statistically significant (r2=0.25; p=0.061). However, the medical costs disease significantly increased by 21.6% during the 11-year period (r2=0.34; p=0.03). The peak age strata of medical costs for UUT stone disease was 70-79 years in both gender.
Conclusions: The present study provides important information on the increasing trends in medical utilization and cost of stone disease in Taiwan. The reason why LUT stone disease exists more in older age may be related to the prevalence of bladder outlet obstruction in the elders.