台灣地區居民口腔保健行為及牙醫醫療利用之探討

The Exploration of Oral Health Behaviors and Dental Care Utilization in Taiwan

蔡名喩(Ming-Yu Tsai)

指導教授 ： 王俊毅

亞洲大學/健康學院/健康管理研究所/碩士(2011年)

摘要

背景與目的：口腔疾病問題會影響口氣清新，阻礙人際關係發展，更會降低咀嚼能力，引起腸胃道疾病，甚至還會影響個人的生活品質。為了維持良好的口腔功能，最好的方法就是建立正確的口腔保健行為。台灣地區長期存在著醫療資源分配不均的問題，造成山地離島地區居民就醫的可近性受到限制，使其不易得到良好的醫療照顧。本研究目的旨在探討平地與山地離島地區居民之社會人口學、口腔保健行為與牙醫醫療利用，及三者間之相關性。
方法：本研究利用2001年行政院衛生署國民健康局及財團法人國家衛生研究院提供之「國民健康訪問調查」原始資料檔，選出18~64歲之族群，與2000~2002年個案同意串聯「全民健康保險資料」進行串檔。收集研究對象三年內牙醫醫療利用情形，以SPSS 12.0進行統計分析。
結果：平地及山地離島地區居民之社會人口學分布除性別外其餘均有顯著差異。平地地區居民一天刷牙至少2次與使用牙線之比率高於山地離島地區居民，而使用漱口水的比率則為山地離島地區居民略高。牙醫醫療利用方面，平地地區居民半年內有洗牙者佔17.7%、山地離島地區居民佔11.7%；一年內就醫原因不分平地及山地離島，治療性因素就醫之比率高於預防性因素；三年內曾就醫、一年內就醫次數及一年內醫療費用平地地區居民之比率均略高於山地離島地區居民。以複迴歸及Logistic迴歸分析得知性別、年齡、教育程度、婚姻狀況、收入、一天刷牙次數及有無使用牙線等變項為主要影響牙醫醫療利用之因素。
結論與建議：平地地區居民有較好的口腔保健行為及較多的牙醫醫療利用，然山地離島地區居民可能因醫療資源較缺乏及醫療可近性受限等因素，影響其醫療利用。建議應增加山地離島地區居民牙醫醫療資源，提高其就醫可近性，以期讓山地離島地區居民有完整的牙醫醫療照護。

關鍵字

口腔保健行為 ； 牙醫醫療利用 ； 城鄉差異

並列摘要

Background & Purposes: Oral diseases could affect breath, hinder the development of interpersonal relationship, reduce the ability to chew, cause gastrointestinal disease, and even affect the quality of life. In order to maintain oral functions, the best way is to have correct oral health habit. There exists a problem in unfair distribution of medical resources over a long time in Taiwan, which results in limited healthcare accessibility and less medical resources for rural residents. Hence, rural residents are less likely to get comprehensive medical care. The study was aimed to understand and explore associations among social-demographic characteristics, oral health behaviors, and dental care utilizations.
Methods: This study used the data from the National Health Interview Survey Original Database provided in 2001 by the Bureau of Health Promotion, Department of Health, Executive Yuan and National Health Research Institutes. Only people who aged from 18 to 64 were enrolled. Dental care utilization of subjects who agreed to be registered in National Health Insurance Database from 2000 to 2002 were then to be merged. All statistical analyses were conducted by SPSS 12.0 for windows.
Results: Most social-demographic characteristics, except for sex, show significant differences between the urban and rural residents. The proportions of “tooth brushing at least twice a day” and “use dental floss” in the urban residents are higher than the rural residents. Yet the rural residents use dental gargling more frequently. The urban residents who regularly go to cleaning teeth are 17.7%, and the rural residents are 11.7%. Regardless of the urban and the rural residents, the reasons for dental visits are more likely to be treatment services than prevention services. The proportion of dental visits in three years, the frequencies of dental visits, and the fees of dental visits in the urban residents are all higher than the rural residents. By the multiple regression and logistic regression, we find that the associated factors of the dental care utilization are sex, age, educational level, marital status, income, frequencies of tooth brushing, and dental floss use.
Conclusions & Suggestions: The urban residents have better oral health behaviors and more dental care utilizations. The rural residents may have less medical resources and limited healthcare accessibility that could affect their care utilization. We suggest increasing dental resources and enhancing healthcare accessibility in rural area, such that rural residents could have comprehensive dental care.

並列關鍵字

oral health behaviors ； dental care utilization ； urban-rural discrepancy

參考文獻

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