探討骨關節炎患者的健康行為、醫療利用與自覺健康狀況之關係

The Correlation of Health Behavior, Health Services Utilization and Self-rated Health Status in Patients with Osteoarthritis

李宛玲(Wan-Ling Lee)

指導教授 ： 許玫玲

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2011年)

摘要

背景及目的：
本研究旨在探究骨關節炎患者之健康行為、醫療利用與自覺健康狀況的影響。本研究利用衛生署國民健康局與國家衛生研究院「94年國民健康訪問調查」與健保資料庫進行串檔之資料，由該訪問調查資料中選取ICD-9-CODE前三碼為715之骨關節炎患者作為本研究樣本以健康生產函數進行分析，排除依變項為遺漏值者，計樣本數為847位。
研究方法：
本研究採與一年前比較之健康狀況的改變作為衡量依變項「健康情形」的指標，自變項包括「醫療利用」及「健康行為」。控制變項則包括社會人口學變項(性別、教育程度、婚姻狀況、工作情形、收入)及個人生理狀況(年齡等)。本研究利用羅吉斯迴歸作為統計分析方法。
研究結果：
在過去一年內自覺健康狀況的改變，骨關節炎患者在健康行為表現中，有運動行為及適量飲酒者其健康狀況較佳，而醫療利用次數愈多者其健康狀況較佳，醫療利用費用愈多者其健康狀況較差，整體而言，骨關節炎病患之健康改變狀況在變項間影響程度微小。
研究結論：
上述研究結果意味遵行健康生活型態才是促進整體健康根本之道。由於醫療資源有限，且因骨關節炎相關疾病所帶來之健康與經濟損害甚巨，相關政策制定者以及醫療服務提供者更應該積極鼓勵骨關節炎患者及早培養健康生活型態以促進其身體健康。

關鍵字

骨關節炎 ； 健康生產函數 ； 自覺健康狀況 ； 健康行為 ； 醫療利用

並列摘要

Background and Objectives:
The purpose of the study is to investigate the health of patients with Osteoarthritis (OA) and their production of health through halth srvices utilization and health behavior. The data is from the National Health Interview Survey conducted by the Bureau of Health Promotion and National Health Research Institutes in 2005. The study selected individuals with Osteoarthritis (ICD-9-CODE=715.xx), but excluded those who had missing data in dependent variables. The final sample is 847.
Methods:
The dependent variable was used to measure health, the self-rated health status. The independent variables consist of health srvices uilization variables (total number of physician and emergency visits and total medical costs of physician and emergency during the past one and half year ), and health behavior variables (drinking, smoking, and physical exercise). Other controlling variables include socio-demographic variables (gender, education, marital status, job, and income), and measures individual physical condition (age, et al.). Logistic regression model was applied for the analyses.
Results:
Results indicated that people who having health behavior (exercising regularly, and drinking less) had better self-rated health status than those who had not. Change in health status was positively and associated with number of physician visits, number of emergency visits during the past one and half year. The magnitudes of the results were small.
The result implies that leading a healthy life style (exercising regularly, and drinking less) is far more fundamental effective in improving overall health status for people with Osteoarthritis. Given that health care resources are limited and the health and economic losses due to Osteoarthritis related diseases are tremendous, policy makers and health care providers should actively encourage people with Osteoarthritis to invest in their health as early as possible.
Key words:
Osteoarthritis, health production function, self-rated health status, health behavior, health srvices uilization

並列關鍵字

osteoarthritis ； health production function ； self-rated health status ； health bhavior ； halth srvices uilization

參考文獻

陳朝宗(2005)。針刺治療對於對膝骨關節炎疼痛評估之預試驗。中醫骨傷科醫學雜誌，7-11。

江東亮、林瑞雄(1994)。吸菸是否會增加醫療服務。中華衛誌，13(3)，214-222。

季瑋珠、楊志新、許駿、賴佳君(2002)。癌症病人特定疾病EORTC生活品質量表簡介。台灣醫學雜誌，6，220-227。

姚開屏(2002)。健康相關生活品質概念與測量原理之簡介。台灣醫學會，6(2)，183-192。

姚開屏(2001)。台灣版世界衛生組織生活品質問卷之發展及使用手冊WHOQOL-BREF(第一修訂版)。台灣版問卷發展小組，台北市。