台灣乳癌病患於診所與醫院中藥使用差異之世代研究

Objectives: Breast cancer is a common cancer in Taiwan. The patients in Taiwan accept not only Western medicine therapies but also traditional Chinese medicine therapies. Most Taiwanese people are insured by the National Health Insurance, so there are already a lot of researches about breast cancer utilizing traditional Chinese medicine. Most Chinese medicine physicians work in clinics, but there is no research about the difference between hospital physicians and clinic physicians. This study is about Chinese herbal medicine utilization among breast cancer patients in Taiwan. Methods: This research was designed to be a cohort study. We investigated the breast cancer patients from 2003 to 2012 who were included in the National Health Insurance Research Database and were assigned the ICD-9-CM codes 174.0-174.9. Male and sex unknown patients were excluded. We followed up the patients who accepted breast cancer surgery and visited Chinese medicine physicians over 3 times for 5 years. The prescription patterns were analyzed between clinics and hospitals. Results: The results indicated that there is no difference between patient characteristics, physician characteristics, and patients’ preferences. But patients who saw Chinese medicine physicians in hospitals is older (p=.01). Moreover, there are significant differences in terms of medical service areas and hospital ownership in Taiwan (p＜.001). Conclusions: There is no difference between hospitals and clinics about the utilization of Chinese medicine compounds. But Chinese medicine doctors who work in hospitals are more likely to prescribe single herbs: Hedyotis diffusa (p=.01) and Semen Ziziphi Spinosae (p＜.001).