目的：癌症病患是感染流行性感冒的高危險族群，而且，自1982年以來癌症一直高居台灣死亡原因的第一位。研究顯示，雖然癌症病患接種流行性感冒疫苗後產生的抗體是相似於一般族群，但是，台灣地區並未特別加強癌症病患接種流行性感冒疫苗的政策，也未有癌症病患感染流行性感冒的相關流行病學研究，因此，本研究目的為探討癌症病患因感染流行性感冒及相關肺炎住院所造成的疾病負擔與醫療成本花費，以提供未來接種流行性感冒疫苗政策之參考。
方法：本研究是收集1997至2003年全民健康保險研究資料庫的住院資料。所有因主診斷碼為流行性感冒及相關肺炎住院的病人均被納入研究對象，次診斷碼則是選取癌症病患。由這些資料分析癌症病患因流行性感冒及相關肺炎住院的住院平均天數、醫療資源耗用和醫療費用，並且，利用衛生署衛生統計和台灣癌症登記資料庫的資料估算每年癌症病患的存活人口數，以估計每年癌症病患因流行性感冒及相關肺炎住院的住院發生率。
結果：1997年至2003年共有1,410位癌症病患因流行性感冒及相關肺炎住院，所有癌症病患因感染流行性感冒及相關肺炎住院的住院發生率是非癌症病患的1.58倍。與一般族群比較，所有癌症病患因感染流行性感冒及相關肺炎住院後的住院平均天數較長(12天 vs. 5天，P<0.0001)，住院期間較需要接受插管治療(2.27% vs. 0.10%，P<0.0001)。癌症病患因流行性感冒及相關肺炎住院之平均住院一天健保支付的醫療費用約為台幣5,587元，每次住院健保支付的總醫療費用約為台幣71,411元，每年健保需支付癌症病患因感染流行性感冒及相關肺炎住院的醫療費用總共為台幣14,384,216元。
結論：癌症病患感染流行性感冒及相關肺炎住院是台灣地區重要的公共衛生問題，未來應加強癌症病患施打流行性感冒疫苗之政策，以減少其感染流行性感冒及相關肺炎後所造成的住院治療數、死亡數和經濟負擔。

Aims：Cancer patients are high risk group of infecting influenza, and cancer is the first cause of death in Taiwan since 1982. Most articles mentioned the humoral response to influenza immunization in cancer patients was similar to general population, but the recommended influenza vaccination schedule doesn’t reinforce cancer patients in Taiwan. In the same time, epidemiology studies of influenza related infections in cancer patients are rare. Therefore, the purpose of this study is to analyze the disease burden and medical costs of influenza and related pneumonia in cancer patients for the recommended influenza vaccination schedule in the future.
Methods：From the NHI Research Database of 1997-2003, we created a sample included discharges with principle diagnosis code for influenza and related pneumonia and next four diagnosis codes for cancer. We analyzed the influenza and related pneumonia hospitalizations in terms of average length of stay, resource utilization and expense in cancer patients. Furthermore, using information of Health and National Health Insurance Annual Statistics and Taiwan Cancer Registration System to estimate the cancer patients and described the rates of influenza and related pneumonia hospitalizations in cancer patients.
Results：Between 1997 and 2003, there were 1,410 cancer patients who hospitalized with influenza and related pneumonia. The estimated rate for influenza and related pneumonia hospitalization in the cancer patients was higher than non-cancer patients, and the cancer-non-cancer hospitalization RR for hospitalization due to influenza and related pneumonia infections was 1.58. Comparing to general population, cancer patients with diagnosed influenza and related pneumonia of the average length of stay was longer (12 days vs. 5 days，P<0.0001), and needed more further mechanical or artificial ventilation during hospitalization (2.27% vs. 0.10%，P<0.0001). Moreover, mean medical cost was NT 5,587/day, mean medical cost of each hospital stay was NT 71,411, and total costs were NT 14,384,216/year.
Conclusions：Cancer patients who hospitalized with influenza and related pneumonia were a serious public health problem in Taiwan. To reinforce the recommended influenza vaccination schedule for cancer patients and reduce hospitalizations, deaths and economic burden in this highly susceptible population.

英文部分

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