目標:本文旨在分析台灣地區護理人員執業人數的變化及地理分佈,並探討醫療網計畫對其分佈的影響。方法:首先,計算歷年護理人員執業人數,接著求出各年的Gini值,以瞭解歷年執業護理人員地理分佈的情況。此外,為探討實施醫療網計畫是否促進護理人力較均勻分佈於各縣市之間,運用時間數列分析方法,先找出護理人力Gini數列之原始變動模式,再以虛擬變數方式導入Box and Tiao所提出的介入模式進行分析。結果:每位護理人員服務的人口數由1976年的1,443人降為2000年的280人,顯示護理人力的供給數量已大幅增加。而護理人員數與醫師人員數比,已由1976年的0.898增加為2000年的1.899,顯示衛生人力的結構已改變。其次護理人力城鄉分佈不平均的情形,已日漸改善。實施醫療網之後的期間,約改善了2.25%的分佈不均度,其改善效果達統計顯著水準。結論:護理人力的供給數量已大幅增加,衛生人力的結構已改變,地理分佈不平均的情形,已日漸改善,藉由衛生政策的實施來改善護理人力地理分佈不均是可行的方法之一。
The purposes of this article are to analyze the change and geographic distribution of nursing manpower in Taiwan and to elucidate the influence of a medical network plan on the geographic distribution of nursing manpower. Methods: First, the total number of nursing professionals and the relevant Gini index are calculated. Second, a time series, combined with the model proposed by Box and Tiao, is applied to understand the geographic distribution of nursing professionals in Taiwan. Results: The population per nurse has declined from 1,443 in 1976 to 280 in 2000, indicating that the supply of nursing manpower has greatly increased. Additionally, the proportion of nurses to doctors has increased from 0.898 in 1976 to 1.899 in 2000. The structure of the manpower has changed. The geographic distribution of nursing manpower in urban and rural areas has also significantly improved by 2.25% following the implementation of the medical network plan. Conclusions: Both the supply and the geographic distribution of nursing manpower have improved. The enforcement of health policy is one possible means of equalizing the geographic distribution of nursing manpower.