偏遠山區醫療需求之研究

中文摘要本次研究題目最主要是要探討偏遠山區醫療需求之研究，台灣目前計有48個山地及離島地區分別分布在全台12個縣市中，也因環境特殊，地區遼闊，交通不方便，醫療資源缺乏，無法有效利用現有醫療制度與資源，其醫療服務的明顯不足，亟待加強山地離島地區的醫療服務。本研究中研究發現在社會人口學變項中「性別」、「年齡」、「教育程度」、「家庭收入」等項目的交叉分析中，在「醫療可近性與效率評估」的選項中呈現選擇鄉內「診所」、「距離近」，為得分較高項目，顯示出偏遠山區的醫療需求存在著「可近性」的問題尚待解決。在選擇鄉外就醫選項中，選擇鄉外就醫的醫院有「提供住院及手術服務」、「醫療技術好」為得分較高項目，顯示出偏遠山區的醫療資源的分配不均與不足。在「醫療資源因素」中，選擇須設立「急診」、「牙醫」則有顯著相關。而由於台灣65歲以上人口已佔總人口數10.6%，已經成為高齡化社會（老年人口占總人口的7％）。在「醫療資源因素」中，選擇須設立「居家衛教」、「復健中心」、「老人日間照護」、「安養機構」等醫療機構的選項也逐步增加中。顯使出高齡化社會的醫療需求，在偏遠山區醫療需求的選項中逐步升溫與加劇。未來醫政單位仍需持續加強偏遠山區的醫療政策執行，除已執行中的「全民健康保險山地離島地區醫療給付效益提升計畫(IDS計畫)」。落實執行外，也可鼓勵其他民間企業投入離島及偏遠山區醫療業務的參與度，於租稅優惠、設立獎項等方面著手，鼓勵企業參與，重新塑造企業社會責任。俾能疏緩偏遠山區醫療可近性及醫療資源不均的問題。

關鍵字

醫療可近性；醫療需求；偏遠山區； IDS計畫

並列摘要

Abstract The research mainly focuses to explore the medical needs in 48 remote mountains and outlying island areas which were distributed in 12 counties of Taiwan. Because of the special and vast circumstances, inconvenience transportation, lack of medical resources, unable to use the existing health care system and resources effectively; it’s the need to enhance the medical services in mountain and outlying Islands areas due to obviously inadequate medical services. This research found that the variables of "gender", "age", "education level”, and “household income” in cross-analysis of social demographic, appear that “township clinic”, "close" are higher scores in “medical care accessibility and efficiency assessment" option, and this shows that “accessibility” of the medical needs in the remote mountain areas have to be resolved. In the option of medical treatment outside the township, “provides inpatient and surgical services” and "medical technology" are the higher scores in the project of choosing hospital for in the medical treatment, and it shows the uneven and unequal allocation of medical resources in the remote mountain areas. Moreover, set up "ER" and "dentist" has significant correlation in the option of medical resource factors. Taiwan's population aged over 65 takes 10.6% in the total population, and has become an aging society (definition: 7% of elderly population in the total population is an aging society). In medical resource factors, to establish "home medical education", "rehabilitation center, "elderly day care", "nursing homes" and other medical institutions are also gradually increasing. It all appears significant medical needs of an aging society, even in the remote mountain areas. In the future, medical administrative units still need to continue to strengthen the implementation of health care policy in the remote mountain areas. Except the IDS Plan implementation, to have tax incentives, establish the awards, to re-shaping corporate social responsibility in order to encourage other private businesses to invest in the participation of medical projects in the outlying islands and remote mountain areas. Therefore, it can relieve the problem of medical care accessibility and uneven medical resources in the remote mountain areas.