醫師人力供給的多寡是否會影響被保險人的門診利用？－1994年國民醫療保健調查之發現

Does Supply of Physicians Affect the Use of Ambulatory Services by the Insured? - Findings from the 1994 Taiwan Health Interview Survey

朱僑麗(Chiao-Lee Chu) ； 薛亞聖(Ya-Seng Hsueh) ； 江東亮(Tung-Liang Chiang)

《中華公共衛生雜誌》 19卷5期 (2000/10) Pp. 381-388

https://doi.org/10.6288/CJPH2000-19-05-08

摘要

檢視醫師人口比值的高低對有保險者西醫門診利用率的影響。方法：以有保險者為分析對象，採用兩部分模式(Two-Part model)進行分析，將醫療次區域中每萬人口醫師教分為高、中、低三組，檢視醫師數的高低對西醫門診利用的影響。有關個人門診利用與基本資料的來源，為1994年台灣地區國民保健調查資料，有關居住地區的醫師人口比資料來源，為1994年行政院衛生署的醫事八實現況調查與內政部編印的台閩地區人口統計。結果：控制了其它相關影響變項後，地區內醫師數量的多或少，對有保險者的門診醫療利用機率及次數並未造成顯著差異。結論：台灣地區醫療資源分佈雖不完全平均，但並未導致民眾醫療利用顯著的差異。是否穠示就醫可近性較差地區民眾已付出較高的時間及交通成本以尋求必要的醫療，值得注意與改善。(中華衛誌2000;19(5):381-388)

關鍵字

醫師人力 ； 門診利用 ； 健康保險

並列摘要

Objective: To examine the effect of the number of physicians on the utilization of ambulato-ry services for insured persons. Methods: The insured population was the target population in this study, and a two-part analysis was used in this study, To test the impact of physician supply on ambulatory care utilization, we categorized the medical care sub-regions for three levels according to the density of medical doctors: low, median, and high. Information about individuals' medical utilization was collected from the 1994 Taiwan Health Interview Survey (THIS). The physician- to-population ratios for each region were obtained from the 1994 Medical Care Manpower Survey in Taiwan compiled by the Department of Health and from the Taiwan-Fukien Demographic Fact Book published by the Ministry of the Interior, Republic of China. Results: After controlling for extraneous factors, the effect of the number of community physicians on the use of ambulatory services by the insured was not found to be statistically significant for the differences among the high, median, and low groups. Conclusion: Therefore, there is insufficient evidence to support the view that the presence of fewer community physicians have discouraged the utilization of ambula-tory services by the insured. However, whether this indicates that people with less medical re-sources where they live have paid higher time and transportation costs to obtain the needed care deserves further investigation for policy formulation.

並列關鍵字

Physician manpower ； Ambulatory services utilization ； Health insurance