- 期刊
以醫療服務利用行為模式探討影響慢性病患之就醫因素
Understanding Behavioral Pattern of Medical Service Utilization Based on Medical Factors Affecting Patients with Chronic Diseases
摘要
目的：探討慢性病與年齡、性別與所在地之關聯性，期望能藉此妥善規劃適切醫療資源與服務模式。方法：研究對象為南部某醫學中心門診就醫之16.9萬位病患，研究期間為2016年7月1日至2016年12月31日，進行描述性統計、顯著性檢定及Logistic Regression分析。結果：民眾就醫疾病：惡性腫瘤、糖尿病、因檢查和診察而接觸醫療保健服務、食道、胃和十二指腸疾病、代謝性疾患及病毒性肝炎。除惡性腫瘤與食道、胃和十二指腸疾病外，性別達顯著差異。除因檢查和診察而接觸醫療保健服務與病毒性肝炎外，年齡達顯著差異。除食道、胃和十二指腸疾病外，縣市別及行政區達顯著差異。Logistic Regression分析，屏東縣病人因惡性腫瘤就醫為高雄市病人的1.641倍，≧65歲者因糖尿病就醫為＜65歲者的2.627倍，女性因檢查和診察而接觸醫療保健服務為男性的2.420倍，≧65歲者因食道、胃和十二指腸疾病就醫為＜65歲者的1.549倍，≧65歲者因代謝性疾患就醫為＜65歲者的1.982倍，屏東縣病人因病毒性肝炎就醫為高雄市病人的0.911倍。結論：為提供非高雄市民惡性腫瘤醫療衛教資源及取得相關醫療訊息，醫學中心應朝向和當地醫療機構建立合作模式。
並列摘要
Objectives: To explore the relationship of chronic diseases with age, sex and location, so as to aid the planning of medical resources and service models in small geographical areas. Methods: The study population comprised 169,000 patients who visited the outpatient clinic of a medical center in Southern Taiwan during July to December 2016. Their descriptive statistics were recorded and analyzed through significance testing and logistic regression analysis. Results: The main factors noted were as follows: malignant neoplasms; diabetes mellitus; Persons encountering health services for examination and investigation; Diseases of oesophagus, stomach and duodenum; metabolic disorders and viral hepatitis. Significant gender differences were noted for all factors, except items malignant neoplasms and Diseases of oesophagus, stomach and duodenum; similarly, significant age differences were noted for all factors, except items Persons encountering health services for examination and investigation and viral hepatitis, and administrative region differences (county or city related) were noted for all factors, except item metabolic disorders. Logistic regression analysis indicated that for items malignant neoplasms and viral hepatitis, the patients were 1.641 and 0.911 times more likely to be non-Kaohsiung residents than Kaohsiung residents, respectively; for items diabetes mellitus, Diseases of oesophagus, stomach and duodenum, and metabolic disorders, they were 2.627, 1.549, and 1.982 times more likely to be aged ≥65 years than aged ＜65 years, respectively; and for item Persons encountering health services for examination and investigation, they were 2.420 more times likely to be female than male. Conclusions: Collaboration should be established between medical centers and local medical organizations to provide healthcare education regarding malignant neoplasms to non-Kaohsiung residents, so as to allow them to obtain relevant medical information.