全民健保醫療照護可近性之探討—以地理資訊系統(GIS)為分析工具

社會保險為我國憲法所揭櫫的基本國策，也是邁向現代福利國家的表徵。我國於民國八十四年三月一日起實施全民健保，在強制納保的規範下，健康平等權成為全民健保的重要議題之一，民眾擔負相同的健保費用，自該得到等量同質的醫療資源。但是醫療資源的配置卻受制於地理條件的根本差異，多數都市居民可享受高倍數及高品質的醫療服務，而偏遠鄉鎮僅能在貧乏的資源中，遷就於不合比例的社會預護。全民健保既為憲法所規範的衛生保健事業，即必須保障全民可獲致相等的醫療效益，醫療院所的合理建置將是強制納保的必要條件，也確保人民支應保費並享有相等醫事服務的對價性。檢閱相關學術研究，許多文獻對於健保資源的區域分配多所探究，然而皆侷限於統計數值的表列，缺乏空間資訊的呈現，故此研究將運用地理資訊系統作為分析工具，結合屬性資料、數值及空間資訊，將不同層級的醫療院所，依其地理區位的劃定，以地圖的方式呈現台灣醫療資源的分配概況。

關鍵字

全民健保；地理資訊系統；醫療可近性

並列摘要

Social insurance is a stated national policy in the Constitution of the Republic of China, it is also protrated by the government as a symbol for a modernized welfare state. On March 1, 1995, the National Health Insurance (a compulsory social insurance policy) was officially activated by the government in Taiwan. Due to its compulsory nature, health equality has become one of the most important issues related to this policy: equal medical accessability for equal insurance premium. However, the distribution of medical resources has been seriously skewed by geographic constraints. To ensure that the policy goals as stated in the Constitution can be effectively achieved, the urban-rural gap in terms of the quantity and the quality of medical service received by people living in different geographic areas has to be reconsidered. Literature review has revealed that there are many researches been devoted to analyze the regional distribution of health care resources, but their results are simply reporting statistical analysis, spatial factors have not been integrated into these studies. This research utilizes the Geographic Information System as the analytical tool, the geographic distribution of different layers of medical institutions in Taiwan is drawn by integrating attributive and spatial data.