Please use this identifier to cite or link to this item: https://ah.lib.nccu.edu.tw/handle/140.119/113308
題名: 少子化對婦產科醫事人力的影響
The impact of low fertility rate on obstetrics and gynecology workforce
作者: 張語珊
Chang, Yu Shan
貢獻者: 連賢明
Lien, Hsien Ming
張語珊
Chang, Yu Shan
關鍵詞: 醫病比
人力短缺
婦產科醫師
Obstetrician-gynecologist-to-female population ratios
Short-handed
OBGYN
日期: 2017
上傳時間: 2-Oct-2017
摘要: 少子化問題使婦產科醫師的工作環境受到衝擊,人力短缺情形嚴重,為了解並預測未來婦產科醫療服務市場的供需情形,本研究使用1997-2011年健保資料庫數據,以及戶政司與經建會人口資料,分析婦產科醫師的人力變動特性及趨勢。\n研究結果顯示,雖然產科醫師人數持續下滑,但由於出生人口持續降低,反而讓每1000出生人口對比醫生數有逐漸提高趨勢,人均年接生水準也可大致維持在固定水準。此外,新進婦產科醫師過少,7成以上的醫師又集中在45至64歲,未來當主要供給人力面臨退休年齡時,婦產科醫師總數將迅速減少,使婦產科醫師與女性人口醫病比隨之下滑。深究婦產科醫師人數減少的緣由,發現少子化的影響程度有超過7成6的比例,同時也發現,醫療環境不佳確實也會影響新進醫師的選擇。政府若欲解決婦產科醫師人力缺乏問題,需著重增加醫學生選擇進入婦產科的誘因。
To examine the current supply of practicing obstetrician-gynecologists and project the future supply under low fertility rate, a discrete actuarial supply model was developed. Supply projections were examined using visiting information form the National Health Insurance research databases.\nWe found the numbers of obstetrician is expected to continuously decline from its current level, whereas the number of obstetrician/gynecologists (OB/GYNs) per 1000 births will still increase because of the declining number of births. Besides, the number of obstetrician per 1000 births can be roughly maintained at a fixed level.\nProjections show that the total supply of OB/GYNs will sharply fall in recent years because the number of new physicians continues to diminish, while more than 70% of workforce is over 45 years old. Among two possible factors affecting growth or decline, the ones that seem most important is low fertility rate. These results highlight the necessity for developing a work environment that attracts young physician to obstetrics and gynecology.
參考文獻: Baker, T.D., and Perlman, M. (1967), “Health manpower in a developing economy: Taiwan, a case study in planning,” The Johns Hopkins University Press, Baltimore, Maryland.\nChen, M.K., and Lowenstein, F. (1985), “The physician/population ratio as a proxy measure of the adequacy of health care,” Int J Epidemiol, 14(2), 300-303.\nCooper, R.A. (1994), “Seeking a Balanced Physician Workforce for the 21st Century,” JAMA, 272(9), 680-687.\nDall, T.M., Gallo, P.D., Chakrabarti, R., West, T., Semilla, A.P., and Storm, M.V. (2013), “An Aging Population And Growing Disease Burden Will Require A Large And Specialized Health Care Workforce By 2025,” Health Aff., 32(11), 2013-2020.\nIde, H., Yasunaga, H., Kodama, T., Koike, S., Taketani, Y., and Imamura T. (2009), “The dynamics of obstetricians and gynecologists in Japan: A retrospective cohort model using the nationwide survey of physicians data,” The Journal of obstetrics and gynaecology Research, 35(4), 761-766.\nJacoby, I., Meyer, G.S., Haffner, W., Cheng, E.Y., Potter, A.L., and Pearse, W.H. (1998), “Modeling the future workforce of obstetrics and gynecology,” Obstetrics & Gynecology, 92(3), 450-456.\nKoike, S., Matsumoto, S., Kodama, T., Ide, H., Yasunaga, H., and Imamura, T. (2009), “Estimation of physician supply by specialty and the distribution impact of increasing female physicians in Japan,” BMC Health Services Research, 9:180.\nMerritt Hawkins (2017), “White Paper Series —— Demonstrating Community Need for Physicians”, cited from : https://www.merritthawkins.com/uploadedFiles/mhawhitepapercommunityneed.pdf\nNicholson, S., and Propper, C. (2012), “Medical workforce,” Handbook of Health Economics, 2, 873-925.\nReuben, D.B., Zwanziger, J., Bradley, T.B., Fink, A., Hirsch, S.H., Williams, A.P., Solomon, D.H., and Beck, J.C. (1993), “How many physicians will be needed to provide medical care for older persons? Physician manpower needs for the twenty-first century,” Journal of the American Geriatrics Society, 41(4), 444-453.\nSatiani, B., Williams, T.E., Landon, M.B., Ellison, E.C., and Gabbe, S.G. (2011), “A critical deficit of OBGYN surgeons in the U.S by 2030,” Surgical Science, 2, 95-101.\nTerhune, K.P., and Abumrad, N.N. (2009), “Physician shortages and our increasing dependence on the international medical graduate: Is there a mutually beneficial solution?,” Journal of Surgical Education, 66(1), 51-57.\nYuji, K., Imoto, S., Yamaguchi, R., Matsumura, T., Murashige, N., Kodama, Y., Minayo, S., Imai, K., and Kami M. (2012), “Forecasting Japan`s physician shortage in 2035 as the first full-fledged aged society,” PLoS ONE, 7(11): e50410.\nShih Yuan (2015),「累到快崩潰...澎湖三總婦科人力緊繃,全縣嬰兒僅由1醫師接生」,關鍵評論網,2015年9月10日報導。取自:https://www.thenewslens.com/article/24340\n行政院經濟建設委員會 (2012),中華民國2012年至2060年人口推計,ISBN:978-986-03-3030-4。\n洪錦墩 (2007),「台灣地區中醫師人力現況分析及未來需求之推估」,《中醫藥年報》,27 (4),27-152。\n陳妍臻 (2016),《以系統動態觀點探討台灣婦產科醫師供給與需求之研究》,元智大學社會暨政策科學研究所碩士論文。\n陳筱華、祝道松、徐永新 (2001),「病患選擇醫院之關鍵因素及決策行為-以產科病人為例」,《醫務管理期》,2 (1),77-92。\n郭政芬 (2017),「桃竹婦產科醫師不足 孕婦夜診苦等到半夜」,聯合新聞網,2017年4月6日報導。取自:https://udn.com/news/story/7266/2385949\n張曉卉 (2012),「畢業生寧可做白工 也要卡皮膚科缺-台灣醫療大崩盤」,康健雜誌,164。取自:\nhttp://www.commonhealth.com.tw/article/article.action?id=5039468\n黃元惠,王貴英,洪志洋,張北葉 (2004),「全民健保實施後外科專科醫師人力下降的可能因素探討」,《台灣醫界》,47(4),40-43。\n黃曉令、藍忠孚 (1997),《台灣地區不同執業科別醫師所得之研究》,國立陽明大學公共衛生學研究所碩士論文。\n游暢帆 (2016),《台灣地區婦產科專科醫院醫療服務市場趨勢變化:區域差異和服務項目延伸及成效探討》,高雄醫學大學醫務管理暨醫療資訊學系碩士在職專班碩士論文。\n臺灣婦產科醫學會 (2017),《台灣婦產科醫學會訊》,243,12。\n熊昭、張毓宏、詹惠婷、范辰蔚、曾鈺珺、李芳娟 (2013),《內、外、婦、兒及急診專科醫師人力評估及醫學生選科偏好評估計畫》,衛生福利部 102 年度科技研究計畫 ( PG10303-0343)。\n潘星宇,林志峰,蕭景隆,葉姿伶,劉婷渝,楊淑涵 (2013),《台灣地區婦產科醫師流動狀況之研究》,中台科技大學醫療暨健康產業管理系專題研究論文。\n鄧麗萍,「蘇怡寧跳脫健保框架 打造最強的產科艦隊」,今周刊,2015年6月5日。 取自https://buzzorange.com/2015/06/05/obstetrics-and-gynecology/\n國立國會圖書館 (2007),産科医療の問題点,《ISSUE BRIEF》,No.575。(日文)
描述: 碩士
國立政治大學
財政學系
104255010
資料來源: http://thesis.lib.nccu.edu.tw/record/#G0104255010
資料類型: thesis
Appears in Collections:學位論文

Files in This Item:
File SizeFormat
501001.pdf2.25 MBAdobe PDF2View/Open
Show full item record

Google ScholarTM

Check


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.