高雄市某行政區健康評估之研究

A Study on Health Assessment of An Administrative District in Kaohsiung

張益誌(Yi-Chih Chang)

指導教授 ： 鄭雅愛 ； 高月慈

義守大學/醫學院/醫務管理學系/碩士(2017年)

摘要

目的：本研究目的在於運用社區健康評估的概念來發現問題、整合相關資源、擬定相關配套措施和解決方案，並且針對所發現的健康問題，了解對社區造成的健康影響及提出改善策略，以促進社區的健康狀態。
方法:以高雄市某行政區為研究對象，研究期間為2008-2011共4年來進行社區健康評估;以八大系統為主軸，並且運用文獻探討、次級資料分析、健康評估方法分析資料，以SPSS for windows 18.0套裝軟體進行統計分析。
結果: 本研究之個案行政區總人數平均為29,903人，以老年人口居多，經濟屬於中下階層，教育程度普遍偏低，國小畢業以下老年人佔老年人口數的80%。經過資料分析後發現，死因排名前三者為惡性腫瘤、心臟疾病及肺炎。其平均死亡率分別為150.23、61.28、51.6 人/每十萬人口。以獨立樣本t檢定與全國資料進行比較，惡性腫瘤(p=0.003)和肺炎(p=0.028)呈現顯著性的差異，其心臟疾病(p=0.341)沒有顯著性的差異。其中，肺炎的標準化死亡率均比全國的還高，且有逐年增加的趨勢。
結論: 該個案行政區的健康改善策略需特別注意老年人相關疾病以及其危險因子，並且透過健康促進的活動，向社區民眾宣導正確的健康觀念，進而改善個案行政區的健康狀況，達到預防重於治療的目標。

關鍵字

社區健康評估 ； 死因排名 ； 死因統計

並列摘要

Purpose: The purpose of this study is to identify issues, integrate related resources and develop related supporting measures and solutions by applying the concept of community health assessment, as well as understand the impacts of the identified issues on community health and propose an improvement strategy for community health enhancement.
Methods: Community healthy assessment was conducted on an administrative district in Kaohsiung City over a four-year period from 2008 to 2011 and was based on eight major systems. In addition, a literature review was conducted; secondary data analysis and health assessment methods were used for data analysis; and the software SPSS for Windows 18.0 was used for statistical analysis.
Results: The administrative district assessed in this study has an average population of 29,903, most of which are older adults in lower middle economic status and with generally low education, i.e. 80% of the older adults being elementary school graduate or lower. Data analysis reveals that the top three causes of death are malignant tumor, heart diseases and pneumonia and their average mortality rates are 150.23, 61.28 and 51.6 (persons/population of 100,000), which are significant different from national average mortality rates of malignant tumor (p=0.003) and pneumonia (p=0.028). The standardized mortality ratio of pneumonia is higher than all the others across the nation and is increasing every year.
Conclusion: The health improvement strategy for the assessed administrative district should seek to improve general health in the district and achieve the goal of prevention over treatment by focusing particularly on diseases related to old age and risk factors for these diseases and educating community members on correct health concepts.

並列關鍵字

community health assessment ； cause of death ； cause of death statistics

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