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臺灣醫療次區域醫院產業擴張與診所醫師人力消長的關係

The Relationship between the Expansion of the Hospital Industry and the Growth of Office-Based Physician Manpower in Sub-Medical Regions in Taiwan

摘要


Objective: To examine the relationship between the expansion of the hospital industry and the growth of office-based physician manpower in sub-medical regions in Taiwan. Methods: We used the sub-medical region as the unit of analysis. There were tow study periods: 1995-1995 (early stage) and 1997-1999 (late stage). Data for the analysis came from “The National hospital and Services Survey” and “Taiwan-Fukien Demographic Fact Book”. The expansion of the hospital industry was measured using three indexes: the growth in hospital bed supply, the growth in hospital physician manpower, and the growth in hospital outpatient services. Multiple regression analysis was applied to explore the relative importance of early versus late expansion of the hospital industry to the growth of office-based physician manpower in the sub-medical region. Results: Between 1995 and 1999, the supply of hospital beds, the number of hospital physicians, and the volume of outpatient services provided by the hospital increased by 5.9%, 16.8%, and 21.8%, respectively. Through using multiple regression analysis, we found that the expansion of the hospital industry was negatively associated with the growth of office-based physician manpower in the sub-medical region, and that the early-stage expansion was more important than the late-stage expansion. However, after controlling for the physician-population ratio, we found that only the growth of hospital physician manpower in the early stage and the growth of outpatient services in the early stage were significantly related to the growth of office-based physician manpower (p<0.05). Conclusions: The expansion of the hospital industry in the early stage is important in determining the growth of office-based physician manpower in sub-medical regions in Taiwan.

並列摘要


Objective: To examine the relationship between the expansion of the hospital industry and the growth of office-based physician manpower in sub-medical regions in Taiwan. Methods: We used the sub-medical region as the unit of analysis. There were tow study periods: 1995-1995 (early stage) and 1997-1999 (late stage). Data for the analysis came from “The National hospital and Services Survey” and “Taiwan-Fukien Demographic Fact Book”. The expansion of the hospital industry was measured using three indexes: the growth in hospital bed supply, the growth in hospital physician manpower, and the growth in hospital outpatient services. Multiple regression analysis was applied to explore the relative importance of early versus late expansion of the hospital industry to the growth of office-based physician manpower in the sub-medical region. Results: Between 1995 and 1999, the supply of hospital beds, the number of hospital physicians, and the volume of outpatient services provided by the hospital increased by 5.9%, 16.8%, and 21.8%, respectively. Through using multiple regression analysis, we found that the expansion of the hospital industry was negatively associated with the growth of office-based physician manpower in the sub-medical region, and that the early-stage expansion was more important than the late-stage expansion. However, after controlling for the physician-population ratio, we found that only the growth of hospital physician manpower in the early stage and the growth of outpatient services in the early stage were significantly related to the growth of office-based physician manpower (p<0.05). Conclusions: The expansion of the hospital industry in the early stage is important in determining the growth of office-based physician manpower in sub-medical regions in Taiwan.

參考文獻


Chie WC, Chang SH, Yang HF(1997).Factors affecting specialty and location of practice of government-sponsored physicians in Taiwan.96,535-41.
Ernst RL, Yett DE(1985).Physician location and specialty choice.Ann Arbor, MI:Health Administration Press.
Holmes JE, Miller DA(1986).Factors affecting decisions on practice locations.61,721-6.
Hurdle S, Pope GC(1989).Physician productivity: trends and determinants.26,100-15.
Magnus Jill Tollan A(1993).Rural doctor recruitment: does medical education in rural districts recruit doctor to rural areas?.27,250-3.

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