鉈心檢查次數與其影響因子之探討

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標題:	鉈心檢查次數與其影響因子之探討 A Study of Thallium Heart Scan Service Frequencyand It’s Affecting Factors
作者:	林璟源
貢獻者:	醫務管理系陳?箖林為森
關鍵字:	鉈心檢查心血管疾病時間序列分析 Thallium-201 Myocardial Perfusion Scan CAD Time Series Analysis
日期:	2015
上傳時間:	2015-10-21 17:09:05 (UTC+8)
摘要:	摘要近年來心血管疾病已成為國人最主要的死亡原因，心臟檢查可提供醫師相關診斷與治療的依據，以降低死亡率。鉈心檢查是一種非侵入性的心臟檢查，除了可以提供診斷治療資訊外，亦可以提供病人方便的檢查流程，且大幅降低對心臟檢查的危險性。本研究的主要目的為探討鉈心檢查次數的分佈趨勢，使用氣候、科別、檢查及社經等構面變項，探討這些變項對鉈心檢查次數的影響，並利用實際醫院樣本資料分析找出預測鉈心檢查次數之最佳模式。本研究屬於縱貫回溯性研究，使用時間序列分析 Box-Jenkins 方式建構預測模型以預測鉈心檢查次數。本研究資料取自南部某區域教學醫院，以2008年至2013年間之資料建立預測模式，並以2014年資料為實際值進行預測模式之準確比較。利用最高溫、最低溫、平均相對溼度及總降雨量等為氣候影響因子；心血管內科、心血管外科、家醫科、急診等科的就醫人次數為科別影響因子；心導管檢查人次數為檢查影響因子，股市指數作為社經影響因子，以預測核子醫學科的鉈心檢查次數。結果發現氣候構面中的最低溫與平均相對溼度、科別構面中的心血管內科就醫人次數是核子醫學科鉈心檢查次數的顯著預測因子。研究結果可以提供醫院相關部門進行設備與人力資源調配與政府相關部門擬定相關健康照護政策之參考。關鍵字：鉈心檢查、心血管疾病、時間序列分析 AbstractCardiovascular disease has recently became the main cause of death. Cardiac survey can offer associated diagnosis and treatment, and decrease the mortality rate. Tl-201 myocardial perfusion scan is a non-invasive cardiac examination. In addition to diagnostic and therapeutic information, it also provides easier procedure for diagnosis, and extremely lower the risk of complications. The major purpose of this study is to find the distribution trend of the number of thallium exams according to the weather, department, and socioeconomic variables. We try to discuss the influence of these variables toward the thallium study number, and find the best model to predict exam frequency using hospital database. This is a longitudinal retrospective study. By using Box-Jenkins method, we choose the most suitable model to predict the number of total thallium studies. Our data comes from a teaching hospital at southern Taiwan. We established the predict model using the data from 2008 to 2013, and compare with the actual value in 2014. The weather variables include highest and lowest temperature, average moisture and total rain amount. The division variable include cardiovascular physician, cardiovascular surgeon, family medicine and emergency department. Affecting factor of the exam is the number of people receiving cardiac catheterization. Stock index was selected as a socioeconomic factor. We use these variables to predict the thallium study number. Our result showed the significantly predict factors of thallium study service frequency include lowest temperature and average moisture in the weather, and the amount of visiting people at cardiovascular division. The result can provide the thinking reference in equipment and human resource management of hospitals and healthcare strategy of government.Keywords: Tl-201 myocardial perfusion scan, CAD, Time Series Analysis.
關聯:	網際網路公開：2020-09-11，學年度：103，110頁
顯示於類別:	[醫務管理系(所)] 博碩士論文

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