Health Resources Distribution in Taiwan

臺灣地區衛生資源之置配

石曜堂(Y. T. Shih)

《Journal of Medical Sciences》 2卷4期 (1978/07) Pp. 703-717

摘要

本文係利用現存資料觀察分析臺灣地區之衛生經費、衛生措施及衛生人力之配置情形並比較縣市間之差異。在衛生經費方面，從民國48年到民國64年間政府的衛生支出雖年有增加但其在政府支出中始終估著較低的比率，加多的衛生經費除滿足人口增加及通貨膨脹，維持舊有的固定支出外能用於開發新衛生計劃的經費仍嫌短缺。從縣市衛生經費看，五大都市用去了二十一縣市衛生經費的一半，而其人口數只達全臺的百分之二十七。在衛生人力方面，牙醫師及護士短缺嚴重。牙醫師、護士、藥劑師地區性分配不勻的現象較之醫師明顯。從數量上看，臺灣地區每一醫療院所服務範圍為3.89平方公里，應能滿足需要，然因醫療院所功能不足及分配不勻致僻遠地區無法獲得理想之照護。

並列摘要

Government health expenditures, health facilities, health manpower in Taiwan and each of their variations among localities were examined. The proportion of the total governmental budget allocated to health tended to remain at a fairly stable level from 1959 to 1975 in Taiwan. A large fraction of the money spent on health services was absorbed in maintaining established services and in providing for the necessary expansion to meet population increases and inflation, leaving only smaller fraction for new programs, improvements, and extended coverage. About half of the total local government health expenditure has been spent in five major cities where 27 percent of Taiwan population resides.Shortages of dentists and nurses are severe. The loss of nurses due to early retirement is high. Uneven distribution of hospital beds and health manpower exist between urban and rural areas. The uneven distribution of dentists, nurses, and pharmacists are more apparent than that of physicians. Except for five major cities, 16 other counties have lower health manpower ratios per 10,000 population than are the ratios for Taiwan as a whole. The rural population is thus apparently underserved. Yunlin County has the lowest number of hospital beds and fewest health manpower ratio per 10,000 population for each type of manpower.Quantitatively, 3.89 square kilometer area coverage per health facility in Taiwan should be enough to effectively deliver health care in this tiny island. However, the quality of hospitals is low, the overall bed-occupancy rate of government hospitals is not high. The existing medical care facilities have been rather poorly mobilized and organized. The desirable expansion of the functions of the health centers are jeopardized by financial and personnel constraints.