山地鄉醫療照護成效及健康監測指標評估-以高雄縣為例

Aboriginal Health Care Effectiveness and Health Monitoring Indicators to Assess -for example in Kaohsiung County

鄭明聰(CHENG MING-TSUNG)

指導教授 ： 藍守仁

亞洲大學/健康學院/健康產業管理學系健康管理組/碩士(2011年)

摘要

台灣地區山地鄉因地理環境特殊，病患因交通方式進出不便，就醫可近性及方便性均不及平地都會區方便；醫護人員編制和醫療設備亦較平地都會地區相對不足。加上山地居民生活習慣和風俗文化的特異性，以及就業和經濟情況均不佳等因素之影響，其醫療服務資源和健康狀況的問題一直備受政府相關單位關注。在當地醫療政策已然執行多年，且現況問題的成因可能已隨時間而有所改變，因而有評估之必要，甚至實際成果與預期成果間的差距，均有賴監測指標來判斷。
本研究目的有二：(一)山地鄉醫療照護成效評估；(二)監測山地鄉健康差距之量化性指標評估。
研究結果與發現如下：
1. 影響山地鄉居民健康的因子包括：交通、教育程度、經濟狀況、自覺健康和生活品質，以及醫療利用率。
2. 「交通」和「經濟」會影響山地鄉居民醫療利用情形，但「教育」和「健康行為」也會影響醫療利用情形。
3. 政府相關政策主要在降低山地鄉居民「就醫可近性」障礙，照護成效評量指標多與「公平性」和「主觀性福祉」有關。
4. 山地鄉與臺灣地區的健康差異會受到醫療利用差異影響，但也會造成醫療利用的差異。且兩者間的差異除了表現在「生活品質」的生理方面，也表現在心理、社會方面。

關鍵字

原住民 ； 山地鄉 ； 醫療服務 ； 監測指標

並列摘要

Taiwan's aboriginal townships because of the special geographical environment,patient inconvenience due to transportation access, medical care accessibility and convenience are not convenient to the metropolitan area and the ground; establishment of medical staff and medical equipment areas will be relatively less than the ground. With aboriginal living habits and customs and culture-specific, and employment and poor economic conditions and other factors are the impact of its health care resources and health problems has always been of the relevant government units concerned.
Already in the local health policy for many years, and the causes of the current situation may have changed over time, and thus the assessment of need, or even the actual results and the gap between the expected results, both rely on monitoring indicators to determine.
This study has two purposes:
(a) assess the effectiveness of aboriginal health care.
(b) monitoring the gap between aboriginal health indicators of quantitative assessment.
The results and findings are as follows:
1.Affect the health of aboriginal residents factors include: transportation, education level, economic status, perceived health and quality of life, and medical utilization.
2. "Traffic" and "economy" will affect mountain and rural residents use the medical situation, but "education" and "healthy behavior" can also affect medical care utilization situation.
3. Relevant government policy is mainly mountainous and rural residents in reducing "medical treatment can be nearly" of obstacles, many indicators of care and assess the effectiveness of "fairness" and "subjective-being" relevant.
4. Taiwan's aboriginal health disparities will be differences affect medical care utilization, but also cause health care utilization differences. And in addition to the differences between the performance of the "quality of life," the physical aspect, but also in psychological and social aspects.

並列關鍵字

aboriginal ； health care ； monitoring indicator

參考文獻

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