以Andersen模式探討影響6~12歲兒童牙醫醫療利用因素之研究

Factors Associated with Utilization of Dental Services among Children Aged 6 to 12 in Taiwan

葉韋汶(Wei-Wen Yeh)

指導教授 ： 董和銳

亞洲大學/健康學院/健康管理研究所/碩士(2009年)

摘要

在1998年全民健康保險牙醫總額預算制度下，醫療支出仍然不斷上升。根據衛生署統計，台灣開始牙醫服務使用有漸漸上升的趨勢。牙醫使用增加代表公共衛生發展進度的階段，特別是在兒童牙醫門診使用量的增加。
本研究主要探討6~12歲兒童與使用兒童牙醫門診之相關因素。以Andersen模式作為一個準則去選擇過去幾年可能會去使用牙醫的變項，而研究之資料取自2005年國民健康訪問調查個人問卷(12歲以下)對2187名6~12歲兒童進行調查，並以邏輯式回歸模型去評估牙醫使用的重要因素。
統計分析結果顯示，一天刷牙或清潔口腔次數、牙醫預防檢查(不含治療)、父母親教育程度、家中收入對兒童牙醫門診利用都有顯著相關。
Andersen行為模式是用來確定使用醫療服務的潛在因素。研究結果顯示在使能(Enabling)方面對兒童牙醫門診利用有顯著影響，例如:家中收入、牙醫師分布，也就表示在台灣醫療服務方面，我們應該在政策上做更多努力，以求在提供服務系統可以更加地公平。

關鍵字

兒童牙醫門診利用 ； Andersen行為模式

並列摘要

As a way of containing the soaring medical expenditure, a global budgeting scheme for dental services under the National Health Insurance (NHI) was launched in 1998. However, according to the statistics from the Department of Health, the use of dental services in Taiwan has steadily increased since then. Usually, an increase of dental use is an indicator for advanced stages in public health development, especially an increase of dental use among children.
This study explores the factors associated with dental use among children 6 to 12 years old. Andersen’s Behavioral Model was used as a guideline for selecting variables to predict the likelihood of visiting a dentist during the past year. The study data were taken from the 2005 National Health Interview Survey. A total of 2187 children aged 6 to 12 were identified from the survey and logistic regression models were used to evaluate the importance of variables in predicting dental use.
The results show that older children, number of teeth-brushing, preventive dental check, parents education levels, household income, density of dentists, and health status were significant predictors for dental use in the past year.
Andersen’s behavioral model was developed to identify potential barriers of access to medical services. Our results showed that enabling factors, such as household income and density of dentists, had greater impact on the use of dental services, indicating that more policy efforts should be made to create a more equitable delivery system for dental services in Taiwan.

並列關鍵字

Dental Use among Children ； Andersen’s Behavioral Model

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