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Taiwan J Oral Med
Health Sci 2002; 18: 51 -58
Printed in Taiwan, All rights reserved
◆《高屏澎地區齲齒重覆填補分佈情形之探討》
本研究主要目的在探討牙齒重覆填補情形之分佈及變化情形，資料來源為中央健康保險局「醫令及處方明
細檔」，以88年8月至90年8月申報醫療費用之牙醫院所為研究對象，計450萬筆資料，利用描述性統計之平
均值、標準差、次數分配及分析性統計之變異數、相關、複迴歸分析等進行分析。研究結果發現：(一)牙醫
醫療院所發生重覆填補之比率，不論是乳牙或是恆牙旳填補，重覆別家院所的情形比院所自身重覆的情形多
，此種情形單由基層牙醫院所來看更為明顯。(二)牙醫醫療院所發生自家牙體復形重覆處置，在本研究中發
現第二年重覆填補之比率較第一年高，主要應為支付標準規定之影響。(三)由醫療資源的變項呈現，專任牙
醫師數愈少的牙醫醫療院所，院所發生自家重覆填補的機會愈大。(四)由牙醫醫療院所所在地區別與都市化
位階之不同，發現愈都市化、人口愈集中，填補的發生率愈有上升的現象，乳牙之情形又比恆牙嚴重。(五)
醫學中心層級之牙醫醫療院所自家重覆比率低者，其重覆其他院所之比率反而較高，故無法以單一比率斷言
其醫療品質良莠。建議衛生主管機關，除監控醫療費用之成長外，應顧及費用支付之公平性及合理性，並應
進一步瞭解醫療費用改變之原因，以作為政策修定之參考。
關鍵字：牙體復形、重覆填補、審查給付期間
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Taiwan J Oral Med
Health Sci 2002; 18: 51 -58
Printed in Taiwan, All rights reserved
◆《The
Re-filling Distribution for Dental Caries in Kaohsiung and Pingtung
Area》
The purpose of this study was to determine the distribution
and variation in refilled teeth in the Kaohsiung and Pingtung
area. Data were collected from Bureau of National Health Insurance
databank declared by dental clinics or hospitals from
Aug '98 to Aug '01. Four and one-half million cases analyzed
were statistically analyzed.
The following results were obtained: (1) the refill ratio. the
result of refilling restorations that other clinics made was
much
higher than those made by the same clinics. Regardless if the
restorations were on deciduous or permanent teeth. This was
more prevalent if the data were analyzed exclusively from local
clinics. (2) The refill ratio in the second year was much
higher than in the first year because dentists must obey the
dental work warranty. (3) From the medical resource point of
view, the ratio of refilled restorations made by the same clinics
where fewer dentists attended patients was much higher.
(4) The ratio of filling restorations was higher in urban and
densely populated areas. (5) The restoration refill ratio conducted
by the original medical center was lower. However. the restoration
refill ratio conducted by clinics others than the original
was higher. Nevertheless, the quality of medical. treatment
was difficult to determined.
According to the study results, it is suggested that hygienic
supervisors not only monitor the growth of Medicare fees but
also ensure that payments are reasonable and impartial to understand
why the Medicare fees change. The supervisors, based
on this understanding, should be able to adjust the hygienic
policy.
Key words：operative dentistry, re-filling.
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| ◎ 2002, Taiwan
J Oral Med
Health Sci,
ISSN1560-1587 |
| Graduate Institue Of Oral Health Sciences
Kaoshiung Medical University |
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