研究背景
　　嚴重特殊傳染性肺炎（COVID-19）疫情大流行對醫療量能的各個方面皆造成影響，而憂鬱症亦成為全球公共衛生領域急需關注和解決的重要問題。因此，需進一步研究在疫情流行期間對台灣憂鬱患者的醫療利用和照護成效，來改善患者的健康狀態並降低其對社會的影響。
研究目的
　　了解嚴重特殊傳染性肺炎（COVID-19）疫情流行期間憂鬱患者人口學、臨床特性與資源利用及醫療照護成效之現況，進而探討疫情期間憂鬱患者人口學、臨床特性與資源利用及醫療照護成效之相關性。
研究方法
本研究為回溯性資料庫分析，研究期間為2018年1月1日至2023年2月28日止共計6年。選取患者為20歲含以上、就醫診斷碼為ICD-10診斷F32、F33之人口學基本資料與醫療紀錄共計821人，使用STATA15.0版本統計軟體，依序進行描述性與推論性統計分析。
研究結果
　　平均門、急診住院總費用為 120294.3 ± 289809.6元及平均門診就診次數約為 7.90 ± 9.898人次呈現顯著上升趨勢（p< 0.001），平均急診就診次數約為 0.80 ± 1.712人次，平均住院治療次數約為 0.80 ± 1.313人次在疫情前期為最多（p< 0.001）。
結論
隨著疫情進展憂鬱患者的醫療總費用及門診就診顯著上升，特別是在最嚴重的疫情前期急診就診和住院治療顯著增加，這反應疫情對心理健康照護需求的影響，而且指出醫療系統在處理突發公共衛生事件時面臨的難題。此外，建議在傳染性疫情等公共衛生緊急情況下，能透過電話、簡訊、問候卡、視訊會議等方式積極關懷憂鬱患者，並加強宣導衛生福利部心理健康司提供的免費心理關懷全國諮詢及救援服務專線，以擴大其服務範圍並提升患者的心理支持。
關鍵字：嚴重特殊傳染性肺炎、憂鬱症、醫療資源利用、健康照護成效、花費

Background: The COVID-19 pandemic has impacted all aspects of healthcare capacity, and severe depression has become a critical issue that urgently needs attention in the global public health field. Further research is necessary to investigate the medical re-source utilization and the healthcare outcome for patients with depression in Taiwan during the pandemic, in order to improve their health status and reduce their influ-ences to the society.
Objective: To understand the demography, clinical characteristics, medical resource utilization, and healthcare outcome of patients with depression during the COVID-19 pandemic. Furthermore, to explore the correlations between these factors during the pandemic, and analyze the relationship between depressive patients and their resource utilization during this period.
Material and methods: This 6-year retrospective study (January 1st, 2018-February 28th, 2023)) includes patients no less than 20 years old with the diagnosis of ICD-10 codes F32, F33. A total of 821 patients' demographic data and medical records were analyzed using STATA version 15.0, followed by descriptive and inferential statistical analyses.
Results: The average total cost on depression patients in outpatient departments, emergency rooms, and inpatient departments were NT$120,294.3 ± 289,809.6. The av-erage visits for every patient in outpatient departments were approximately 7.90 ± 9.898 times, 0.80 ± 1.712 times for emergency rooms, and 0.80 ± 1.313 times for hos-pitalizations. During the COVID pandemic, the average total cost increased signifi-cantly (p<0.001). The average emergent visits increased to 0.98 ± 1.750 times which showed significant difference during the mid-pandemic period (p<0.001). The average visits for hospitalization showed significant changes (p<0.001), rising to 0.89 ± 1.281 times in the mid-pandemic period.
Conclusion: With the progression of the COVID-19 pandemic, the average total cost on depression patients in outpatient departments, emergency rooms, and inpatient de-partments showed significant increase. Particularly, during the hardest time, mid-pandemic period, significant increases of the visiting-times in emergency rooms and inpatient departments were noted. This phenomenon not only reflects the impact of the pandemic on the demand for mental health care but also highlights the challenges for healthcare systems when dealing with sudden public health crises. Additionally, show-ing concerns for the depressives via phones, text messages, caring cards and video chats is recommended under the urgent, public health circumstances. And the advoca-tion of the free-of-charge global consultation and rescue service line provided by the Department of Mental Health, Ministry of Health and Welfare should be encouraged, hoping to expand the range of service and improve the patients’ mental supports.
Keywords: COVID-19, Depression, Medical care utilization, Healthcare outcome, Cost

論文審定書 i
中文摘要 ii
Abstract iii
目錄 v
圖次 vii
表次 viii
第一章 緒論 1
第一節 研究背景與研究動機 1
第二節 研究目的 2
第二章 文獻探討 3
第一節 嚴重特殊傳染性肺炎 3
第二節 憂鬱患者對醫療資源利用及照護 5
第三節 嚴重特殊傳染性肺炎對憂鬱患者就醫行為與影響 7
第三章 研究方法 10
第一節　研究設計與架構 10
第二節　研究問題與假設 12
第三節　研究樣本與資料來源 12
第四節 研究變項之操作型定義 13
第五節　資料處理與分析 14
第四章　研究結果 17
第一節　研究樣本基本資料及就醫特性描述 17
第二節　研究樣本各變項對醫療資源利用之情形 23
第三節　研究樣本各變項對醫療資源利用之影響 28
第四節　假設驗證 33
第五章 研究討論 34
第一節 憂鬱患者之人口學及臨床資料特性 34
第二節 憂鬱患者醫療資源利用之相關性 36
第六章 研究結果與建議 40
參考文獻 42
附錄 48

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