医疗服务可达性距离成本估算方法：对台湾地区政策和患者隐私的影响。

Estimation method for distance cost to access medical services: Policy and patient privacy implications in Taiwan.

机构信息

Head Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.

Department of Public Health, Tzu Chi University, Hualien, Taiwan.

出版信息

Front Public Health. 2022 Dec 22;10:1065742. doi: 10.3389/fpubh.2022.1065742. eCollection 2022.

DOI:10.3389/fpubh.2022.1065742

PMID:36620287

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9815447/

Abstract

INTRODUCTION

Indicators of healthcare access with high reliability, validity, timeliness, and easy application can aid in an understanding of the supply and demand of a region's medical resources and assist governments in allocating resources more effectively. However, a key concern when developing indicators is the protection of private information, such as patients' residential addresses.

OBJECTIVES

We develop an estimation method for distance cost using official public information, including a region's disease prevalence rates and population.

MATERIALS AND METHODS

The method accounts for patients' privacy and addresses limitations associated with using the National Health Insurance Database. This cross-sectional study conducts a secondary data analysis using SPSS and QGIS. The data were divided into a validation group and an index development group with the medical distance calculated for each group. Data for the validation group were sourced from the medical records of patients with diabetes ( = 108-164) and hypertension ( = 243-348) in Yuli documented by a medical center in 2017-2019, and the data for the novel index development group included diabetes and hypertension prevalence sourced from national official public data. The study compared the consistency of the two groups' medical treatment distances to verify the accuracy of the estimation method.

RESULTS

The estimated distances for the index development group showed a high consistency (ICC > 0.9). Further, the index development group had an excellent R-square after adjusting for age (98.1%) and gender (92.7%).

CONCLUSIONS

The proposed method to estimate healthcare on the basis of disease prevalence and population protects patient privacy and can be implemented by local governments.

TRIAL REGISTRATION

This study was approved by the Research Ethics Committee of the Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (IRB109-239-B).

摘要

简介

具有高度可靠性、有效性、及时性和易于应用的医疗保健获取指标，可以帮助了解一个地区医疗资源的供需情况，并协助政府更有效地分配资源。然而，在开发指标时，一个关键问题是保护患者的私人信息，如患者的居住地址。

目的

我们开发了一种使用官方公共信息（包括疾病流行率和人口）估计距离成本的方法。

材料和方法

该方法考虑了患者隐私以及使用国家健康保险数据库相关的地址限制。本横断面研究使用 SPSS 和 QGIS 进行二次数据分析。将数据分为验证组和指标开发组，为每组计算医疗距离。验证组的数据来源于 2017-2019 年玉里一家医疗中心记录的糖尿病（n = 108-164）和高血压（n = 243-348）患者的医疗记录，新型指标开发组的数据包括糖尿病和高血压患病率，来自国家官方公共数据。本研究比较了两组医疗治疗距离的一致性，以验证估计方法的准确性。