影響健保鎖卡率的區位因素分析

AN ANALYSIS OF ECOLOGICALFACTORS THAT INFLUENCE LOCKED CARD RATES OF NATIONAL HEALTH INSURANCE

曹孟儀(Meng-Yi Tsao)

指導教授 ： 張清富

國立臺北大學/社會科學學院/社會學系/碩士(2012年)

摘要

本研究的目的在分析健保被鎖卡者之特質、空間分布及探討影響台灣鄉鎮市區之區位間鎖卡率之因素，鎖卡率以台灣地區 368 個鄉鎮市區之區位為樣本。影響因素部分，以內政部統計處之各鄉鎮市區各項人口指標統計資料為自變項。納入了性比例、年齡結構比率、族群比率、婚姻狀況比率、都市化程度、教育程度比率、扶養比、扶老比、扶幼比、低收入戶人口比率、身心障礙人口比率等因素與各區位之鎖卡率進行迴歸分析，以檢測對鎖卡率的影響。
鎖卡者特質以男性、25-54歲之青壯年人口、投保身分以第6類第2目無職業之地區人口鎖卡率較高，65歲以上老年人欠費鎖卡機率最小，無職業沒有經濟來源仍屬於欠費被鎖卡之主要原因，且與政府之健保費補助政策有關。
就區域分布而言，東部和南部地區鎖卡率較高，鎖卡率最高的前三名依序為臺東縣、花蓮縣及屏東縣；在鄉鎮市區之區位部分，鎖卡率最高之前10名，前9名均屬於原住民鄉，前三名依序為屏東縣春日鄉、屏東縣泰武鄉及南投縣仁愛鄉。
在影響區位鎖卡率因素部分，研究顯示，原住民人口比率、離婚率愈高的地區，鎖卡率愈高；有偶人口比率與高等教育程度比率愈高，則有助於改善鎖卡率問題；而和都市化程度、地區扶養比、扶老比及扶幼比的關係，則結果不明確，且多未能達到統計上的顯著水準。

關鍵字：全民健保、鎖卡率、區位、弱勢族群

關鍵字

全民健保 ； 鎖卡率 ； 區位 ； 弱勢族群

並列摘要

The purpose of this study attempts to analyze characteristics and geographical distribution of the insured holding a locked health insurance card and to explore ecological factors that affect locked card rate in Taiwan area. There are totally 368 districts in Taiwan area. The locked card rate, a dependent variable in this research, is calculated from total insured holding locked card divided by total township population in each township level. Sex ratio, proportion of age structure, proportion of various ethnicity, proportion of various marital status, degree of urbanization, various education rate, dependent ratio(include child dependent ratio and elderly dependent ratio), poverty rate, and proportion of the disabled are used as independent variables, which are taken from demographic data by individual township from the Statistical Department of the Ministry of the interior. A variety of statistical methods are employed in the research. More importantly, regression analysis is a powerful technique to be used to test factors affecting the locked card rate.
The higher ratio in characterization of locked card holders is males, the young population of between ages 25 to 54 and enrolled as the 6th category insured. The senior citizen aged over 65 has the lower ratio. Non-occupation and without income still named as the key point for insured unable to pay their premium, caused their cards were locked by the insurer. It also related by Government policies in premium subsidy.
Regards to the regional distribution, the higher ratio for locked card holders live in the southern and in the eastern of the island. The top three in order is Taitung county, Hualien county and Pingtung county. In township level, locked card prior to the highest rate of 10, top 9 belong to aboririnal townships. The first three is in order for Chunrih, Taiwun ,both from Pingtung county, and Ren-ai, Nantou county.
For ecological factors that influence the locked card rate in the research, the research findings show that the higher the proportion of aboriginal population or the higher divorce rate, the higher the locked card rate; both the higher ratio in married population and education degree are beneficial to reduce the locked card rate. The result is indeterminate for degree of urbanization and dependent ratio(include child dependent ratio and elderly dependent ratio), and almost failed to reach statistically significant difference.

Key words: National Health insurance、locked card rate、ecology、disadvantage groups

並列關鍵字

National Health Insurance ； locked card rate ； ecology ； disadvantage groups

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