個人身心狀況的決定因素 － 居住環境、健康識能與醫療滿意度

Determinants of Individual Health Status－Living Environment, Health Literacy and Medical Satisfaction

許翊亭(I-Ting Hsu)

指導教授 ： 彭祐宜

國立臺北大學/公共事務學院/財政學系/碩士(2014年)

摘要

背景及研究目的
　　本研究要探討的是個人身心狀況的決定因素，由於健康之於人類的重要性是不可被否認的，且隨著時代的改變，個人身心健康狀況的決定因素也會有所不同，因此雖然過去已有許多討論個人健康決定因素的文獻，但本文認為此議題是該與時俱進、且持續被探討的。

研究方法
　　本文採用中央研究院2011年至2012年間執行的「台灣社會變遷基本調查-健康組」問卷做為資料來源，並在文中使用四個模型分析台灣的居住環境、健康識能與醫療滿意度對身體及心理健康狀況所造成的影響。以下是本文中的四個被解釋變數及模型設定：(1)自評健康之Ordered Probit模型；(2)慢性病之Probit模型；(3)BMI之Multinomial Logit模型；(4)心理健康之OLS模型。

結果
　　根據此橫斷面分析結果顯示，醫療滿意度的提升可促進自評健康及心理健康，另外，健康識能較高者心理健康狀況也會較佳，但健康識能在生理健康方面僅對BMI模型呈顯著，對自評健康、慢性病則不具顯著影響。由居住環境變數中則可發現主觀的物理環境因素對身心健康較無顯著影響，但客觀物理環境變數如城鄉差異、工廠及攤販等則會顯著影響身心狀況表現，最後，若由社會環境面因素分析，則可發現社會支持也是影響生理及心理健康的要素之一。

結論
　　衛生當局可經由加強醫療品質、提升人民健康識能、縮減城鄉醫療落差、制定攤販規章、及提倡社會資本等措施來提升大眾的身心健康表現，當然，個人擁有良好的健康習慣，如睡眠充足、頻繁運動等也是基本的保健之道。

關鍵字

醫療滿意度 ； 健康識能 ； 居住環境 ； 健康

並列摘要

Background and Objectives: The purpose of this study is to investigate the determinants of individual health status. There have been many literatures discussing personal health determinants in the past, but according to the importance of health to humans and the health determinants keeping changing with times, we continue to study this issue because the individual health determinants might be different in different period and it is still need to be explored.
Methods: The data come from a Taiwan Social Change Survey executed in 2011 to 2012 by Academia Sinica. Four models have been used to estimate the influence of Living Environment, Health Literacy, and Medical Satisfaction on individual physical and mental health in Taiwan. Including (1) an Ordered Probit model for Self-Reported Health, (2) a Probit model for Chronic Disease, (3) a Multinomial Logit model for BMI, and (4) an OLS model for Mental Health.
Results: The cross-sectional analyses showed that the higher medical satisfaction can improve self-reported health and mental health. Besides, we found that the individuals with higher health literacy have better mental conditions, but health literacy does not have significant effect in the physical health models except for the BMI one. By estimating the living environment variables, we can find that the objective physical environment does not have much influence on health status but the perceived physical environment and the social environment does.
Conclusions: Government can try to improve public health by enforcing the quality of medical care, increasing people’s health literacy, reducing the medical gap between urban and rural area, setting vendors regulations, and encouraging social capital. Of course, keeping the right health habits is still the most basic way to stay healthy.

並列關鍵字

Health Literacy ； Living Environment ； Health ； Medical Satisfaction

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