健康相關行為型態集群與醫療資源利用—以臺灣地區十八歲以上成人為例

Health-related Behavior Clusters and Health Services Utilization among the Adults in Taiwan

許軒豪(shiu shiuan hau)

指導教授 ： 朱僑麗

亞洲大學/健康學院/健康管理研究所/碩士(2007年)

摘要

研究目的：本研究欲瞭解個人健康相關行為所形成之型態集群與 西醫門診、住院與急診等醫療資源利用之間的相關性。 方法：本研究採次級資料分析，分析衛生署國民健康局與國家衛 生研究院共同承辦、管理之「2001 年臺灣地區國民健康訪問調查」 資料庫，分析樣本為臺灣地區十八歲以上人口，計16137 人。 首先先利用集群分析（Cluster Analysis）對個案的健康相關行為 進行集群歸納；隨後以邏輯斯與卜瓦松回歸分析，瞭解在控制其他相 關影響因素下，健康行為集群與西醫門診、住院與急診等醫療資源利 用之間的相關性。 結果：健康相關行為的表現程度經分析後共歸納為三大集群：輕 食保健群，共5893 人，佔全體樣本36.5%；癮君子群共有4146 人， 佔25.8%；沙發馬鈴薯群共6080 人，佔37.7%。 醫療資源利用狀況顯示，過去一個月內曾利用西醫門診的人數為 5909 人，佔全體樣本36.6%；整體平均利用次數為0.73 次。過去一 年曾利用住院醫療的人數為1259 人，佔整體的7.8%；平均利用次數 為0.11 次。過去一年中曾經利用急診的人數為1711 人，佔10.6%； 平均次數為0.15 次。 在控制人口、社會、經濟與自覺健康狀況等因素的影響之下，相 ii 對輕食保健群而言，癮君子群過去一個月內利用西醫門診的機會為 0.786 倍、次數也顯著較少（IRR=0.948）；過去一年住院的機會與次 數則無明顯差異；但過去一年內急診利用機會為1.388 倍，次數 （IRR=1.345）也顯著較高。沙發馬鈴薯群過去一個月內西醫門診的 利用機會與次數無顯著差異；過去一年內的住院機會為0.806 倍、次 數也顯著較低（IRR=0.827）；過去一年急診醫療利用的機會為1.187 倍、次數（IRR=1.165）亦顯著略高。 結論：健康相關行為型態越傾向輕食保健群者，門診與住院醫療 的利用越高；型態越傾向癮君子者，急診醫療的利用越高；越傾向沙 發馬鈴薯者，住院醫療利用越少但急診醫療亦有偏高趨勢。這可能是 因為不同集群者，對於健康的認知與態度上存有差異所致，建議未來 研究可進一步探討不同行為型態的集群者於健康認知、態度與實際醫 療利用內容之差異，並根據其人口特質擬定衛生教育計畫，作為日後 提升對健康的認知與態度，影響醫療資源使用狀況與健康之參考。

關鍵字

健康相關行為、健康相關行為集群、醫療利用、集群分析

並列摘要

Objective:
To examine the relation between the health-related behavior clusters
and the health services utilization that include outpatient, hospitalization
and emergency services.
Data Sources:
The 2001 National Health Interview Survey conducted by the Bureau
of Health promotion, Department of Health and the samples were
included 16137 adults upper 18-year-old living in Taiwan area.
Methods:
Cluster analysis was used to generalize the health-related behaviors at
first. Logistic regression and Poisson regression were used to understand
the relationship between the health-related behavior clusters and health
services utilization that after control the other influences.
Results:
The health-related behaviors were generalized into there clusters:
5893(36.5%) adults were included in the “good diet & fitness cluster＂,
4146(25.8%) adults were included in the “addictive cluster＂, and
6080(37.7%) adults were included in the “couch potato cluster＂.
The results show that 5909(36.6%) adults ever used the outpatient
service in the past month, and the average frequency were 0.73 times;
1259(7.8%) adults ever used hospitalization services in the past year, the
average frequency were 0.11 times; 1711(10.6%) adults ever used the
emergency service in the past year, and the average frequency were 0.15
times.
After controlling the affection from demographic, social, economics
and self-rated health factors, compare to the good diet & fitness cluster,
the addictive cluster had the lowest utilization(IRR=0.948) in outpatient
service in the past month but had the highest utilization(IRR=1.345) in
emergency utilization in the past year; the couch potato cluster had the
lowest utilization(IRR=0.827) in hospitalization service but still had
iv
higher utilization(IRR=1.165) in emergency service in the past year.
Conclusions:
The adults belong to the “good diet & fitness cluster＂ had higher
utilization in outpatient and hospitalization service; those belong to the
“addictive cluster＂ had highest utilization in emergency service; those
belong to the “couch potato cluster＂ had lowest utilization in
hospitalization service but slight higher utilization in emergency service.
Such a phenomenon, perhaps, was due to the difference on the health
knowledge and attitude among the clusters.
We suggest that the further studies could try to investigate the
difference on the health knowledge, attitude and the actual contents of the
health services utilization among the clusters, and design the health
education programs depend on the population characteristics. For the
purpose of promoting the health knowledge, attitude, health service
utilization and health outcome of the adults.

並列關鍵字

health-related behaviors, health-related behavior clusters, health service utilization, cluster analysis

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