適用長期照護政策之特定族群就醫門診的決定因素

Abstract

由於人口老化平均年齡上升、家戶人數逐年下降，使得家庭對於照顧老年人口時的負擔越來越重，所需要的醫療照護人次也越來越多，而行政院在2007核定了「長期照護十年計畫」。\n本文旨在探討自行政院實施長期照護計畫適用之特定族群的就診因素，高門診就醫者的特性，其性別、年齡、有無慢性病與居住地等因素是否都可能影響醫療資源之使用。\n本研究利用健保資料庫2008年至2013年的資料作為研究分析，針對台灣地區的門診資料，從性別、年齡、有無慢性病、居住地、投保金額、投保類別和醫事機構類型以及醫事機構所在地等因素，應用Panel Regression、Probit model及分量迴歸進行資料剖析，觀察門診次數與個人特徵、醫事機構特徵的關聯性。\n研究結果發現，性別、年齡、有無慢性病、投保金額、就醫類型、居住地、醫事機構位置和醫事機構類型等因素，是驅使就醫門診次數差異的原因，上述因素所造成之醫療資源使用的不同，在長期照護計畫實施後民眾看診次數有下降趨勢，未來政府在擬訂醫療政策、社會發展計畫，增進社會福利等，可以將這些特性因素納入參考。

Due to population ageing and the number of households declines year by year, Average age raising. The burden on families to care for the elderly is getting heavier, and the amount of nursing care required is increasing. The Executive Yuan approved the “Long-Term Care Decade Plan” in 2007.\nThe main purpose of this paper is to explore the characteristics of the specific groups fitting the long-term care plan in the Executive Yuan. The characteristics of the high outpatients, whether their gender, age, presence or absence of chronic diseases and located of residence may affect the use of medical resources.\nThis paper used data from the Health Care Database from 2008 to 2013 as a research analysis. The outpatient data in Taiwan were based on factors such as gender, age, presence or absence of chronic diseases, place of residence, amount of insurance, type of insurance and type of medical institution, and location of medical institution. Data analysis was performed using Panel Regression, Probit model and Component regression to observe the relationship between the number of outpatient visits and personal characteristics and medical institution characteristics.\nThe study found that gender, age, presence or absence of chronic diseases, the amount of insurance, the type of medical care, the place of residence, the location of the medical institution, and the type of medical institution are the reasons for the difference in the number of medical visits. The use of the medical resources caused by the above factors is different. After the implementation of the long-term care plan, there has been a downward trend in the number of visits by the public. These factors can be included in the future if the government is studying medical policies, social development plans, and promoting social welfare.