- 學位論文
台南地區勞工就醫選擇考量因素之探討－以下背痛為例
Study on the Factors of Hospital Shopping among Labors in Tainan－Using Low Back Pain for the Cases
摘要
根據行政院衛生署提供的資料，我國總人口大約有百分之八十的比例，曾有短期或長期具有下背痛的病痛經驗，在職業病的相關研究文獻中可以得知，下背痛是常見於各種工作場所中，尤其在進入二十世紀後更是盛行，由國內外的學者專家陸續所進行的研究可以顯現其普遍的盛行率，可以得知下背痛屬於常見的一種職業病，因此具有探討的價值。勞工從前看病幾乎全部自費，在健保實施後改變成只需負擔部份費用，加上近年來醫療院所更為普遍，就醫需求無形中受到刺激，勞工就醫習慣與型態也因而改變，許多以往不願就醫的職業病，因為經濟負擔的減輕，勞工就醫考量因素或許具有重大的改變。就醫選擇的考量因素常是一些無形的、較難量化的質化因素，例如醫師的醫術、醫德、服務態度、聲譽等等。本研究所採取的層級分析法能轉換這些無形的因素成為可評量的指標，使得研究者可以更容易且貼切地評估勞工在下背痛的考量之下，得到就醫選擇因素的相對重要性及對醫院的相對偏好度，成為專家與政府相關部門對醫療政策的評估參考資料，藉此制定具有實質意義與效用的決策。有鑑於此，本研究將以勞工為研究對象，以層級分析法為分析工具，並採用下背痛為例，希望能找出在此種情況下，勞工所考量的就醫因素是否具有差異，以期能對未來政府擬定健保或相關政策時有所助益。 本研究結論如下﹕在下背痛的考量之下，是否具有健保與看診費用，對勞工而言非常重要﹔醫院的層級與設備、醫德與隱私權等的排名亦在前面，顯示勞工對於醫師的道德與個人的隱私頗為重視﹔醫療設施與醫療服務雖然是傳統較受重視的因素，但是與醫療行為無直接關係，此因素在本研究的結果中也發現勞工對於下背痛就醫考量因素，較不會優先考量﹔其他因素的細項評估準則，無論是購物環境或是遊樂設施與視聽設備等對勞工幾乎不具重要性，對於此方面之因素後續研究或許可以忽略。
並列摘要
According to the data provided by Department of Health, Executive Yuan, R.O.C. (Taiwan), eighty percent of the population in our country have experienced short- or long-term low-back pain. From the related literature reviews of occupational diseases, low-back pains are commonly seen in various working places. This phenomenon is even more widespread in the twentieth century shown in the increasing researches in the domestic and abroad studies. Therefore it can be seen that low-back pain is a common professional ailment worth investigating. Laborers used to pay almost all the fees for seeing doctors, but now they need to pay only part of the fees since the implementation of the health insurance policy. Besides, more and more emerging medical institutions have also impacted people’s medical demands, which in turn have changed laborers’ habits and models of treating diseases. Due to the alleviated economic burdens, laborers have significantly changed their altitudes facing their own occupational diseases which might have otherwise been kept at home. The considering factors of hospital shopping are often abstract, qualitative and hard-to-quantify, such as the doctor’s skill, virtue, attitude, reputation, etc. The AHP, which can transform the abstract factors into assessable indicators, enables the researcher to easily and properly assess the relative importance on hospital shopping factors and people’s preferences for hospitals when considering their low-back pain. The findings can be used as references for experts and related government departments to make decisions on substantial and effective medical policies. Hence this study will use laborers as research participants, adopting AHP as analyzing tools and low-back pain as the example to find out any difference in laborers’ consideration in hospital shopping so that the result might be conducive to government’s future health insurance policies. The findings are as follows: in terms of low-back pain, whether or not being covered by the health insurance and being charged of the fees are very important to laborers; the hospital levels/equipment and medical virtues/privacy are also ranked high. These reveal that laborers think highly of the doctors’ personal virtue and individual privacy. Medical facilities and service are traditionally valued, but they are not directly related to medical behavior. In this study, it is found that laborers do not put them on the top of the preference list. Other factor items, such as shopping, amusement or entertainment facilities are of little importance to laborers. Later research in this area might neglect such factors.