初創期群醫中心門診使用率之分析

為了解社區民衆對新開辦群醫中心門診醫療服務利用的情形，本研究以台北縣三芝鄉群體醫療執業中心為例，收集群醫中心自民國78年7月20日開辦以後至民國78年12月31日的門診資料，逐月分析門診使用率，並探討相關因素與使用率的關係。結果平均每月來診病人52.1%(482/926)為女性，47.9%(444/9260為男性；37.3%(345/926)為自費病人，62.7%(581/926)為非自費病人。全社區平均月使用率為5.58%，其中女性使用率(6.33%)高於男性使用率(4.95%)，累積使用率呈穩定增加到12月底為18.04%(2991/16576)年齡方面，平均月使用率最高者為老年人口(14.98%)，其次為中年人口(8.66%)，再其次為幼年人口(4.55%)，最低為青壯年人口(3.04%)。以村別分析，則愈遠離群醫中心之地區平均月使用率愈低，其中埔頭(8.06%)，埔坪(7.41%)兩村最高，店子(0.85%)、興華(0.77%)兩村最低。保險人口（農保為例）8月份年齡標凖化使用率為8.37%（直接法）與7.85%（間接法），均較全社區8月份使用率(5.38%)為高。研究結果顯示高危險群使用率高，而健康保險與交通距離均為影響使用率的重要因素，對使用率偏低的村落，有加強家訪衛教的必要。

關鍵字

無資料

並列摘要

In order to explore the health services utilization of a newly developed group practice center (GPC) in the rural area, medical records of San-Chih GPC, Taipei County, were collected and analysed since opened date July 20, 1989 to December 31, 1989. Monthly utiligation rate and factors relating to utilization rate were investigated. The results showed that 52.1% (481/926) of average monthly GPC users was female, 47.9% (444/926) was male; 37.3% (345/926) was self-payment users, 62.7% (581/926) was partial or total reimbursement users. The average monthly utilization rate of the whole community was 5.58%, female's utilization rate (6.33%) was higher than male's (4.95%). The accumulative utilization rate increased steadily to 18.04% (2991/1650) by the end of December, 1989. As regards age, higher utilization rate were found in the elderly and chilldren group (≤14Y/O); average monthly utilization rate by age were: 14.98% (≥65Y/O), 8.66% (40-MY/O), 4.55% (≤14Y/O), 3.04% (15-39Y/O). Utilizationn rate was inversely related to the distance that from the village center to GPC, 8.06% and 7.41% were found in two nearest villages, 0.85% and 0.77% were found in the most far areas. Age-standardized utilization rate of the people who had farmer's health insurance were 8.31% (direct method) and 7.85% (indirect method) respectively, those two were higher than the utilization rate of the whole community in August (5.38%). This study revealed the high risk age group had higher utilization rate; health insurance and accessible distance were important factors related to utilization of the GPC. Public health services like home visit and health education should be provided to the low utilization area.

並列關鍵字

Group Practice Center ； Utilization Rate ； Accumulative Utilization Rate ； Farmer's Health Insurance

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初創期群醫中心門診使用率之分析

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