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UM E-Theses Collection (澳門大學電子學位論文庫)

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Title

下背疼痛患者對於針灸與物理療法治療選擇的就診偏好

English Abstract

Since Chronic pain has been a public health problem worldwide, and low-back pain is the leading cause of chronic pain, the effectiveness of low back pain therapies and better health care allocation is becoming a more and more popular research topic. The objective of this study is estimating low-back pain patients’ preference for therapies and determining the relative importance of therapy-associated attributes. A discrete choice experiment was used to explore factors that influence low back pain patients’ referral or no-referral decision, and estimate preferences for five key treatment attributes through MRS assessment. Acupuncture, physical therapy and one opt-out option were presented to patients from Traditional Chinese medicinal hospital or general hospital in DCE choice sets. The result of data regression implies that the female patients are more likely to opt out two therapies on offer, while patients who paid larger payment for current treatment and patients with higher education or lighter intensity of pain are less likely to choose the therapy option. From the patients’ perspective, the treatment behavior and feelings experienced during the therapy have greater impact on the clinical utility than the other four attributes. Low back pain patients would like to afford much more money and time for a convincing treatment and certain clinical effect.

Chinese Abstract

背部疼痛作為當前最常見的慢性痛症,其對社會與個人帶來的經濟負擔不容小 覷,如何更有效的對下背疼痛進行治療與醫療資源分配這一話題亦日益受到關注。 瞭解病人對治療方法的評價意見與偏好應當是構成治療方案的重要部分,也是提高 醫療服務效用與優化資源配置的有效途徑。本研究的目的就是通過了解下背疼痛病 人對針灸與理療兩種療法之間的就診偏好,分析其對就診效用的評價受到哪些因素 影響。 本研究採用離散選擇試驗的方法,以問卷形式訪問中醫院與綜合醫院的慢性下 背痛門診病人,結合人口統計學與臨床病史等背景資料,分析哪些特性對下背疼痛 病人決定是否選擇治療造成影響,而患者對針灸和物理治療兩種療法的效用評價與 就診偏好又受何種條件左右,通過邊際替代率的方式來表現這些要素對病人就醫效 用的相對重要性。 研究結果顯示:女性與教育程度越高者更傾向於不選擇就診;而不適程度的影 響則與之相反;自費比例越高,越不願意選擇就診;其他因素對參與選擇的影響表 現不明顯。同時,研究對象認為治療方法與過程才最重要的一項治療特性;改善越 明顯、療程數越少、費用越低時,就診效用越高。而在確保治療效果時,病人願意 為其信任的治療方式付出比實際臨床更多的費用、接受更長的治療療程。

Issue date

2013

Author

何馨

Faculty

Institute of Chinese Medical Sciences

Degree

M.Sc.

Subject

Consumers' preferences

消費者偏好

Consumer behavior

消費者行為

Pain -- Treatment

疼痛 -- 治療

Supervisor

鄭力仁

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Location
1/F Zone C
Library URL
991005206409706306