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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


行政院衛生署(2002)。中華民國九十年衛生統計。台北:行政院衛生署。
行政院衛生署(1996)。中華民國八十四年衛生統計。台北:行政院衛生署。
中央健康保險局(2002)。中華民國九十年全民健康保險統計。台北:中央健康保險局。
鄭守夏、劉林義、張毓宏(2001)。新設大型醫院對當地基層診所的影響評估。第一部分:供給與利用的變化。20,52-60。
Rundall TO, McClain JO(1982).Environmental selection and physician supply.87,1090-112.

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