個人之健康理想、健康活動參與及社區之健康促進規劃：以台北市某社區健康促進機構為例

Individuals' Ideals of Health, Participation in Health Activities, and Community Health Promotion Planning：The Case of a Health Promotion Institution in Taipei

呂佩璇(Pei-Hsuan Lu)

指導教授 ： 許玫玲

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2013年)

摘要

研究背景與目的：為了使醫療提供者有誘因節約醫療資源、促進民眾健康，健保目前正在試辦論人計酬計畫。該試辦計畫三種模式中唯一的醫療群是欒樹社區醫療群，該醫療群以芝山生活家作為一個民眾健康促進的平台。本研究目的想探討生活家之利害關係人對於自己的健康理想狀態、參與健康促進活動、是否滿足自己現在的生活，以及民眾如何評估芝山生活家對於參與會員在健康促進上扮演何種角色並發揮何種功能。
方法：本研究方法採用質性研究，以深度訪談12位民眾的方式進行，包括8位芝山生活家的會員、1位芝山診所病人但非芝山生活家會員、2位里長與1位芝山診所醫師。
結果：大多數受訪者滿意他們現在的健康與生活狀況，並且認為個人要為自己的健康負責。受訪者對於擁有一個像生活家能增進與支持個人健康的環境是很重要的。生活家會員也指出芝山生活家在會員彼此的關係中扮演著很重要鏈結的角色。因此，生活家的會員們也很關心要如何推廣生活家的理念，讓更多人都能加入這個健康促進活動。總而言之，要在社區中推廣健康促進，像生活家這樣的社會企業在缺乏資金與人力的狀況下是不容易經營的。即便如此，生活家仍然提供了一種新的健康促進模式。本研究建議，政府應該更積極地去支持這種在社區努力、創造更多健康促進模式的私人機構，這樣一來才會有更多類似的健康促進機構得以參考並延續發展。

關鍵字

健康促進 ； 論人計酬 ； 社區醫療群 ； 健康理想

並列摘要

Background and Objectives: In order to encourage providers to use medical resources more efficiently and promote patients’ health, NHI is currently experimenting a capitation payment project. Among the three models of capitation in the project, the only team participating in the physician group model is the Luan Shu Community Healthcare Group. It established a living lab, called Lohas, as the platform for health promotion activities in the community. The research aimed to investigate Lohas’ stakeholders regarding their ideals of health, their participation in health promotion activities, whether or not they are satisfied with their lives, and how would they evaluate the roles and functions of this living lab.
Methods: This study used qualitative method by interviewing 12 people, including 8 Lohas members, one Zhishan Clinic patients who was not a Lohas member, two neighborhood chiefs and one physician of Zhishan Clinic.
Results: Most of the interviewees were satisfied with their health and their lives. They thought individuals should be responsible for their own health. They also agreed that it is very important to have a supporting environment to enhance individuals’ health. Members of Lohas pointed out that Lohas had exactly played such a role and the members had formed a strong bond in their relationship. However, active Lohas members were also concerned about how to promote the concepts of Lohas so that more people in the community can join in this health promotion movement. In conclusion, it is not easy for a social enterprise like Lohas to promote health in the community due to lack of fund and manpower. However, it provides a new model for health promotion. This study recommends that the government should be more active in supporting such private efforts in the communities so that more creative health promotion models can be developed.

並列關鍵字

Health promotion ； capitation ； community healthcare group ； ideals of health

參考文獻

萬文隆(2004)。深度訪談在質性研究中的應用。生活科技教育月刊，37(4)，17-23。

中文部分

文崇一、楊國樞(2000)。訪問調查法。社會及行為科學研究法下冊。臺北：東華。

王英偉(2008)。國際健康促進的發展。醫療品質雜誌，2(2)，4-9。

王勝禾(2010)。臺灣區域間健康差異因素之分析。國立高雄大學應用經濟學系研 究所碩士論文，未出版，高雄。