臺灣公共衛生雜誌 Taiwan Journal of Public Health

27(3) 2008


語  文: 中文 Chinese
論文標題: 全民健保下不同所得群體醫療利用不均因素分析 Decomposition of Income-related Inequality in Health Care Utilization under National Health Insurance in Taiwan
論文作者: 李妙純 Lee, Miaw-Chwen、沈茂庭 Sheen, Mao-Ting
期刊名稱: 臺灣公共衛生雜誌 Taiwan Journal of Public Health
卷  期: 27(3) 出版年月: 2008.06
本期期刊附註:
本雜誌自民國八十六年(1997)起被收錄於下列資料庫:Cambridge Scientific Abstracts (CSA)底下之 Life Sciences Collections, Health & Safety Science Abstracts;及 EMBASE/Excerpta Medica.期刊榮獲行政院國家科學委員會社會科學研究中心補助九十七年度費用。 
起迄頁: 223∼231 引用型式: 參考文獻
補助經費來源: 行政院衛生署中央健康保險局補助研究計畫(計畫編號:DOH95-NH-1015);行政院國家科學委員會專題研究計畫(計畫編號:NSC96-2415-H-194-009) 
關鍵詞: 醫療服務利用;集中係數;水平不公平;臺灣全民健康保險;health care utilization;Concentration Index (CI);Horizontal Inequity (HI);National Health Insurance  
摘要:   目標:台灣在1995年建立全民健康保險(NHI)將全體國民納入為保險對象,重要的政策意涵是希望不論經濟狀況、社會狀態或地理位置,有相同醫療需要的人皆能公平的就醫。本研究目的以集中係數(CI)測量台灣醫療利用在不同收入群體之分布,並分析影響不均的因素。方法:以2001年國民健康訪問調查(NHIS)為研究對象,並串連其2001年全民健康保險門診及住院之就診資料,得到受訪者之實際醫療服務利用資料。結果:西醫門診次數呈現有「扶貧(propoor)」的水平不公平,費用及住院使用呈現不同收入間的使用是能依照其不同的需要而分佈。需要及地區因素是使用次數不均的主要兩大貢獻因素,而需要及收入是費用不均的兩大主要貢獻因素,收入不均會促使醫療服務利用往富人集中。結論:與歐洲國家比較,台灣西醫門診次數處於中度「扶貧」的水平不公平,與實施全民健保制度及對弱勢群體或偏遠地區居民的醫療協助方案習習相關。結果有助於規劃醫療資源分布的政策、建置良好的健康照護體系的參考。 
論文附註:



序號
標題
期刊、書刊名稱
作者 / 編者
出版年
1
Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment 
The American Economic ReviewDuan, N.、Newhouse, J. P.、Manning, W. G.、Keeler, E. B.、Leibowitz, A.、Marquis, M. S. 1987
2
全民健保醫療利用集中狀況及高、低使用者特性之探討 / Concentration of Health Care Expenditures in Taiwan - Analysis of Patient's 
臺灣公共衛生雜誌 / Taiwan Journal of Public Health張鴻仁、黃信忠、蔣翠蘋 2002
3
Equity in the Delivery of Health Care in Europe and the US 
Journal of Health EconomicsWagstaff, A.、Van Der Burg, H.、Van Doorslaer, V. 2000
4
「國民健康訪問調查」之調查設計、內容、執行方式與樣本人口特性 / The Design, Contents, Operation and the Characteristics of the Respondents of the 2001 National Health Interview Survey in Taiwan 
臺灣公共衛生雜誌 / Taiwan Journal of Public Health洪永泰、張明正、林惠生、石曜堂、吳聖良、張鳳琴、劉仁沛、張新儀、熊昭 2003
5
 
Unhealthy Societies: The Afflictions of InequalityWilkinson, Richard G. 1996
6
Equity and Equality in Health and Health Care 
Journal of Health EconomicsCulyer, A. J.、Wagstaff, A. 1993
7
The Effects of Taiwan's National Health Insurance on Access and Health Status of the Elderly 
Health EconomicsChen, L.、Lee, S. D.、Lin, H. S.、Chiu, Y. L.、張超盛、Yip, W.、Lin, Yu-Hsuan、Cheng, M. C. 2007
8
Equity in Health Care: The Role of Ideology 
Equity in the Finance and Delivery of Health Care: An International PerspectiveWilliams, A. H. / Wagstaff, A.Van Doorslaer, E.Rutten, F. 1993
9
推動健保業務成果一年之回顧 
 賴美淑 2008
10
臺灣未納保人口特質及未納保原因的初步分析 
2004年臺灣人口學會年會林季平、林昭吟 2004
11
A Comparison of Alternative Models for the Demand for Medical Care 
Journal of Business & Economic StatisticsDuan, N.、Morris, C. N.、Newhouse, J. P.、Manning, W. G. 1983
12
臺灣醫療資源使用之公平性探討 
醫護科技學刊 / The Journal of Health Science郭乃文、湯澡薰、葉壽山 1999
13
Amending Health Disparities in Taiwan's Indigenous Population 
Harvard Health Policy ReviewChang, H. J.、Chou, Y. J. 2002
14
A Note on the Decomposition of Health Concentration Index 
Health EconomicsGerdtham, U. G.、Clarke, P. M.、Conhelly, L. B. 2003
15
Explaining income-related Inequalities in Doctor Utilisation in Europe 
Health EconomicsVan, Doorslaer E.、Koolman, X. 2004
16
Administrative Data for Public Health Surveillance and Planning 
Annual Review of Public HealthMcBean, M.、Virning, B. A. 2001
17
Health Information and the Demand for Preventive Care among the Elderly in Taiwan 
Journal of Human ResourcesLin, S. J.、Hsieh, C. R. 1997
18
Measuring and Testing for Inequity in the Delivery of Health Care 
Journal of Human ResourcesWagstaff, A.、Van, Doorslaer E. 2000
19
Self-rate Health and Mortality: A Review of Twenty-seven Community Studies 
Journal of Health and Social BehaviorIdler, E.、Benyamini, Y. 1997
20
Disparity of Medical Care Utilization among Different Health Insurance Schemes in Taiwan 
Social Science & MedicineChiang, T. L.、Cheng, S. H. 1998
21
Policy Analysis in an Information-rich Environment 
Social Science & MedicineRoos, L. L.、Menec, V.、Currie, R. J. 2004
22
Horizontal Equity in Health Care Utilization Evidence from Three High-income Asian Economies 
Social Science & MedicineO'Donnell, O.、Lu, J. F.、Leung, G. M.、Van, Doorslaer E.、Kown, S.、Tin, K. Y. K. 2007
23
On the Concept of Health Capital and the Demand for Health 
Journal of Political EconomyGrossman, M. 1974
24
偏遠地區民眾就醫可近性及滿意度調查 / Accessibility to and Satisfaction with Healthcare by Rural Area Residents 
臺灣公共衛生雜誌 / Taiwan Journal of Public Health楊志良、蔡文正、龔佩珍、林思甄、李亞欣 2006
25
Socioeconomic Inequalities in Health: Measurement, Computation, and Statistical Inference 
Journal of EconometricsKakwani, Nanak、Wagstaff, Adam、Van, Doorslaer Eddy 1997
26
Understanding Differences in Income-related Health Inequality between Geographic Regions in Taiwan Using the SF-36 
Health Policy李妙純、Jones, Andrew Michael 2007
27
 
Economics of Health Care Financing: The Visible HandDonaldson, C.、Gerard, K. 1993
28
 
OECD Health Systems: Fact and Trends 1960-1991. Health Policy Studies No. 3.Organisation for Economic Co-operation and Development 1993
29
Income-related Inequality in the Use of Medical Care in 21 OECD Countries 
Organisation for Economic Co-operation and Development Policy StudiesVan, Doorslaer E.、Masseria, C.、OECD Health Equity Research Group Member / Organisation for Economic Co-operation and Development 2004
30
 
SF-36 Health Survey Manual & Interpretation GuideWare, J. E.、Snow, K. K.、Kosinski, M. 2000
31
 
全民健保與您牽手12年:成長與蛻變中央健康保險局 2007
共計:31 筆