臺灣醫師人力地理分布之變遷(1984-1998)

Changing Geographic Distribution of Physicians in Taiwan (1984-1998)

黃偉堯(Wei-Yao Huang) ； 張睿詒(Rau-E Chang) ； 江東亮(Tung-Liang Chiang)

《Journal of Medical Education》 5卷1期 (2001/03) Pp. 13-20

https://doi.org/10.6145/jme.200103_5(1).0003

摘要

本研究旨在分析1984年與1998年間，臺灣醫師人力地理分布的變遷情形。研究資料來自行政院衛生署及臺灣大學衛生政策研究中心之醫師人力資料庫，與內政部出版之台閩地區人口統計。我們使用五項指標來分析醫師人力地理分布的改變情形，包括吉尼指標、變異係數、平均值、醫師不足鄉數、與無醫鄉數等。結果顯示：(1) 在1984年至1998年間，總醫師人口比與診所醫師人口比分別增加77.6%與20.5%；(2) 總醫師人力的地理分布有呈現惡化的趨勢，其吉尼指標增加11.9%，由0.42上升至0.47，然而總醫師人口比小於1/3000的總醫師不足鄉數卻減少27.4%；另一方面(3) 診所醫師人力的地理分布則呈現改善的趨勢，其吉尼指標減少16.7%，由0.30下降至0.25，同時診所醫師人口比小於1/3000的診所醫師不足鄉數也下降25.9%。因此，增加醫師人力總供給可以降低臺灣醫師人力地理分布不均的現象；但在政策上仍有加速改善的空間。

關鍵字

醫師人力 ； 地理分布 ； 吉尼指標 ； 醫療照護可近性

並列摘要

The aim of this study was to analyze the changes in geographic distribution for physicians in Taiwan between 1984-1998. The data were derived from The Physician Manpower Data Bank, compiled by the Department of Health (DOH) and the Center for Health Policy Research at the National Taiwan University, and the Taiwan-Fukien Demographic Fact Book. For this study, we considered five indicators that reflect the geographic distribution of physicians, including the Gini index, the mean physician-population ratio, the coefficient of variation, the number of towns with a physician-population ratio below 1/3000, and the number of towns without a physician, The results show: 1) between 1984 and 1998, the total physician-population ration and the office-based physician-population ratio increased 77.6% and 20.5%, respectively: 2) the geographic distribution for total physicians did not improve as the Gini index increased by 11.9% from 0.42 to 0.47, however, the number of towns with total physician-population ratios below 1/3000 declined 27.4%;and 3) the geographic distribution for office-based physicians improved, with the Gini index decreasing by 16.7% from 0.30 to 0.25, and the number of towns with an office-based physician-population ratio below 1/3000 declining 25.9%. This study concludes that the increase in the supply of physician manpower has ameliorated the geographic distribution of physicians in Taiwan, but, from the perspective of health policy, there is some room for a rapid improvement. (Full text in Chinese)

並列關鍵字

physician manpower ； geographic distribution ； Gini index ； access to medical care