台灣地區內科醫師人力之數量與地理分佈

The Geographic Distribution of Taiwan's Internist Manpower

洪錦墩(Chin-Tun Hung) ； 藍忠孚(Chung-Fu Lan) ； 宋文娟(Wen-Chuan Sung)

《醫務管理期刊》 4卷1期 (2003/03) Pp. 39-54

https://doi.org/10.6174/JHM2003.4(1).39

摘要

內科醫師人力是各類專科醫師中人數及所佔比率最高的一群，更是提供民眾基本醫療服務重要人力資源，本研究由醫師公會全聯會之資料與台灣內科醫學所提供之資料，分別進行醫師數量之趨勢分析與內科醫師人力之地理分布進行分析。結果顯示，內科醫師人力在1998年有6309人，佔整體醫師23.57%。內科醫師數量佔所有醫師科別之比例約為四分之一強，為各專科別醫師人數比例最高。但當1991年至1998年間整體醫師由21,487人增為26,770人增加了24%，而內科醫師人數僅由5,963人增為6,309人增加幅度僅5.7%，是僅次於一般外科負成長率外成長率最低的一個科別。在地理分佈上，內科醫師人力比率較高的五個縣市分別為台北市、嘉義市、台中市、高雄市、台南市，都是都市化程度較高的縣市，且前三名也是整體醫師人力資源最豐富的前三名縣市。而內科專科醫師與人口比率較低的縣市為嘉義縣，而嘉義縣同時也是整體醫師人力資源最差的一個縣市。若以內科專科醫師人力資源較豐富的台北市與資源最差的嘉義縣比較來看，二者相差達五倍之巨。如何加強內科醫師人力之培育，不論是數量上或地理分佈之考量，提高國民使用基本醫療服務之可近性，並加強預防保健服務提供之誘因，進而達成促進國民人人均健的目標，應是未來衛生政策上重要之政策考量重點。

關鍵字

醫師 ； 內科 ； 地理分佈

並列摘要

The highest percentage of medical specialists in Taiwan are internists, providing much of the population's basic medical cam. This study was based on data from the ROC Medical Association and the Taiwan Society of Internal Medicine, analyzing trends in numbers of physicians and their geographic distribution.
In 1998, there were 6,309 internists, accounting for 23.57% or one quarter of all physicians, a number greater than any other specialty. However, from 1991 to 1998, the total number of physicians in Taiwan grew from 21,487 to 26,770, an increase of 24%, whereas the number of internists only grew by 5.7%, from 5,963 to 6,309. This was the second lowest growth rate for all specialties, with the percentage of surgeons actually decreasing over that period.
Geographically, the highest percentages of internists were found in 5 cities: Taipei, Taichung, Kaohsiung, Tainan, and ChiaYi, representing the most highly urbanized areas on the island. The first three have the richest medical manpower resources in Taiwan, while Chia Yi has the lowest total number of physicians, as well as the lowest percentage of internists. Taipei has five times as many internists as Chia Yi.
In order to improve medical care throughout Taiwan, including access to primary care and preventive health services, national health policy must focus on both training and more equitable geographic distribution of internists. There is obviously much scope for growth in internist manpower to help achieve these important health care goals.

並列關鍵字

Physician ； Internist ； Distribution

參考文獻

宋文娟(1998)。健保時期臺灣地區醫師人力供需及其專科結構之政策研究(碩士論文)。國立陽明大學醫務管理研究所。

林芸芸(1999)。全民健康保險對醫師專科分佈的衝擊。醫院。32，1-16。

洪錦墩、藍忠孚、宋文娟(2001)。台灣醫師人力研究之方法學探討。台灣衛誌。20(3)，1-9。

洪錦墩、李卓倫(1989)。以GINI係數分析台灣地區的醫師人力分佈。公共衛生。1(6)，225-232。

張友珊、楊志良(1999)。全民健保對各科醫師消長影響之初探。中華衛誌。18，123-137。