中醫醫療利用成長與醫師數增加之關係

Relationship Between Chinese Medical Utilization and Growth of Physicians

蔡文正(Wen-Chen Tsai) ； 龔佩珍(Pei-Tseng Kung)

《台灣公共衛生雜誌》 20卷6期 (2001/12) Pp. 463-474

https://doi.org/10.6288/TJPH2001-20-06-06

摘要

目的：全民健保實施後醫療費用不斷上漲，假若民眾之健康情形無明顯之惡化，為何醫療服務量成長速度高出人口成長比率甚多，此一問題值得深入探討。本研究主要探討中醫醫療利用之成長與中西醫師數增加有無關係。方法：本研究以衛生署規劃之次醫療區為觀察單位，以民國85至88年間之資料為研究期間，各區域內之每人每年中醫醫療費與利用次數為依變項。共計236個觀察值。應用固定效果模型(Fixed-effects Mosel)為複回歸統計分析模型，並分為平均費用模型及平均次數模型。結果：每萬人口中、西醫師人數、老年人口比率、幼年人口比率、女性人口比率皆顯著影響中醫醫療利用次數與費用。並計算出，每萬人口中西醫師數增加25%，則因中醫師人數的增加醫療利用次數及費用將增加0.39％。每萬人口西醫師數增加25％，則造成平均中醫醫療利用次數及費用減少0.23%。結論：中醫門診醫療稍微存在醫師誘發需求的現象。且民國85至88年中醫門診醫療費用成長中，有1.69%的成長費用導因於中醫師人數之增加。顯示平均中醫醫療利用受中醫師數或西醫師數之增加影響不大。

關鍵字

醫師誘發需求 ； 供給誘導需求 ； 中醫醫療利用 ； 中醫師數

並列摘要

Objectives: After implementation of National Health Insurance in Taiwan, health care expenditure has increased rapidly. If people's general health status has not significantly changed, why has the health care expenditure increased so much? This study examined the impact of the growth of physicians on Chinese medical utilization in Taiwan. Methods: This research used sub-region in health care service network as the observation unit over the period from 1996 to 1999. It contained 236 observation units in total. Average Chinese medical care expenditures per capita per year and average Chinese medical care visits per capita per year were used as the dependent variable. This study applied multiple regression with a fixed-effects model as the means of analysis. Results: Chinese medical physicians per ten thousand population, Western medical physicians per ten thousand population, ratio of aged population (older than 64 years), ratio of young age (less than 15 years), and ratio of female population significantly influence Chinese medical care utilization. If Chinese medical physicians increase 25 percent, Chinese medical care expenditure will increase 0.39 percent. However, if Western medical physicians increase 25 percent, Chinese medical care expenditure will decrease 0.23 percent. Conclusions: Chinese medical care services slightly exhibit a physician-induced demand situation and 1.69 percent increase in Chinese medical care expenditures was caused by the growth of Chinese medical physicians from 1996 to 1999. This implies that the impact of growth of physicians on Chinese medical care utilization is very slight.

並列關鍵字

Physician-induced demand ； Supplier-induced demand ； Chinese medical care utilization ； Number of Chinese medical physicians