本研究利用2005年國民健康訪問調查及全民健康保險資料庫,以就醫機率與頻率的概念探討勞動年齡人口在不同工作狀態下,影響精神醫療使用之因素,作為判斷勞動年齡人口的精神健康狀態。門診就診機率使用Probit模型進行估計,門診頻率方面分為門診支出與門診次數,門診支出使用普通最小平方法進行估計,門診次數則以負二項分配模型估計。 實證結果發現,無工作人口相較於有工作人口有較大的門診機率及頻率。近年國內精神疾病治療發展趨勢,為回歸社區、提供職能諮詢,工作與否能影響精神疾病病況之緩解程度,因此本研究將總樣本群組區分為有工作群組及無工作群組,討論其影響精神健康狀態之異同。研究成果顯示,兩群組使用醫療與否及精神疾病嚴重程度影響因素各有不同。無工作群組的家庭關係(同住人口數與婚姻狀態)對其就醫與否與嚴重程度影響顯著,教育因素的影響力則與過去研究相異,具有分布兩極的情形,學歷極高或極低都有較低的精神疾病問題;有工作群組則可發現所得影響醫療頻率顯著,教育水準也發現以中學為對照下,學歷較高者之精神狀況較差,學歷較低者之精神狀況較佳,因此有其必要將其分開討論。
The purpose of the study is to discuss the factors that influence labor forces’ utilization of mental health care in different working conditions. Data are taken from the 2005 National Health Survey and the 2004-2007 National Health Insurance Database. Probit model is used to analyze the probability of mental health care utilization. Ordinary least squares model and Negative binomial model are used to analyze the frequency of mental health care utilization. The results show that non-working population has more chance of receiving outpatient mental care visits than their counterparts. In other words, working can help alleviate the degree of mental illness. In this study, we further divide total samples to working group and non-working group. It shows that the factors influencing mental health care utilization vary between the two groups. In the non-working group, family relations (numbers of family member and marital status) have significant impact on the probability of receiving mental health care and severity of mental illness. Moreover, the impact of education is found to be different from the literatures. Those with higher or lower education have less mental illness problems than their counterparts. In the working group, income significantly influences mental health care frequency. In addition, compared to high school education individuals, those with higher education have poor mental health but those with lower education have better mental health.