臺灣成人肥胖對醫療使用及慢性病之影響

The Impact of Obesity on Medical Utilization and Chronic Disease among Taiwanese Adults

黃彥慈(Yen-Tzu Huang)

指導教授 ： 張宏浩

國立臺灣大學/生物資源暨農學院/農業經濟學研究所/碩士(2011年)

https://doi.org/10.6342/NTU.2011.03235

摘要

隨著時代進步、經濟發展與環境變遷，以及人們生活型態及飲食行為之改變，肥胖人口已逐年增加且有急遽上升之趨勢。因此肥胖問題已是長久以來大眾所關注的焦點，亦為全球健康及醫療的重要議題。然而，肥胖議題之研究大多出現在公共衛生領域之文獻，肥胖對慢性病患病率及醫療使用之影響程度鮮少有完整量化的探討，且臺灣有關肥胖與醫療使用及醫療費用之研究仍略顯不足。因此本研究目的即為彌補過往文獻之不足，嘗試量化肥胖對門診、住院之醫療費用及醫療使用及其對慢性病患病率之影響效果。
本研究資料來源為2001年國民健康調查串聯全民健保資料庫，以18歲以上之成人共11,096個樣本為研究對象，利用Two Part Model及Bivariate Probit Model作為實證模型，分別探討肥胖對醫療使用及對慢性病的影響。實證結果發現，在醫療使用方面，相對於正常體位者，過重、肥胖女性之住院費用、過輕女性之門診費用、肥胖男性及女性之門診次數皆較高，然而男性BMI體位則對門診及住院醫療費用無顯著影響。此外，不論男性或女性，BMI體位皆與住院次數無顯著相關。在慢性病患病率方面，肥胖對慢性病有顯著之正向影響，過重或肥胖民眾得到慢性病之機率高出30.1%。
本研究結果發現，肥胖對醫療支出及醫療使用有正向相關，對慢性病患病率亦較高。相對於其他體位之成人而言，正常體位之成人，不僅醫療費用及醫療使用較低，慢性病患病率亦較低。本研究亦發現男女在醫療費用及醫療使用次數皆有差異，過輕體位之民眾亦可能增加其醫療費用，因此政府應宣導民眾正確的體重認知及健康觀念。透過均衡飲食及良好運動習慣，使BMI範圍保持在正常合理的最佳狀態，除給予肥胖民眾有效且健康控制體重之完整配套措施，更應考量性別因素產生之差異，不僅可減少醫療成本，亦可減少國家之經濟負擔。

關鍵字

肥胖 ； 醫療使用 ； 慢性病 ； Two Part Model ； Bivariate Probit Model

並列摘要

Due to the growth of economic development and the consequently changes in lifestyle behaviors, the prelevence of obesity is drametically increased. To date, obesity has been one of the important public health issues around the world. A considerable body of literature has focused on this topic. However, most of the existing studies are in the field of public health. Little attention has been paid to quantify the effects of obesity on chronic disease and medical utilization conditions. To fill the gap of the existing studies, this paper investigates the effects of obesity on the likelihood of having chronic disease conditions and medical utilization in Taiwan.
In total, 11,096 adults aged 18 and above drawn from the National Health Interview Survey and National Health Insurance Profiles in 2001 were selected for empirical analysis. The Two Part Model and Bivariate Probit Model were estimated respectively. Results show that compare to normal weight adults, women who are overweight and obese have higher inpatient expenditures; women who are underweight incur higher outpatient expenditures. The results also reveal that obesity contribute to higher outpatient visits. On the contrary, BMI status plays no role in determining the outpatient expenditures and inpatient expenditures for men. In addition, BMI is not significant of the inpatient visits as well. Nevertheless, obesity is positively associated with the likelihood of having chronic diseases. Compared to the normal weight adults, those who are overweight or obese have higher likelihood of being chronically illness by 30.1%. These results suggest that it is neceesary for the government to promote the healthier lifestyle to keep the body shape of the adults in normal weight status.

並列關鍵字

Obsity ； Medical Utilization ； Chronic Disease ； Two Part Model ； Bivariate Probit Model

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