所得與癌症存活率之關聯-以台灣地區公務人員為例

The association of income and cancer mortality and medical utilization rates - the case of the civil servants in Taiwan

王美齡(Mei-ling Wang)

指導教授 ： 蔡偉德

國立中央大學/管理學院/產業經濟研究所碩士在職專班/碩士(2012年)

摘要

本文旨在探討所得與癌症存活率之關聯，使用全民健保資料庫1996年至2008年之資料進行研究，透過承保檔、門診費用檔、住院費用檔、重大傷病檔，篩選參加公務人員保險且患有肝癌、肺癌或胃癌之病患資料，探討其1年、2年、3年死亡率是否受病患個人所得及其他特性變數等影響。再以病患存活1年、2年、3年期間之就醫費用，評估其受個人所得及其他特性變數之影響程度。因此本文藉由Probit及OLS為實證模型，建構癌症患者死亡率及醫療利用率與個人特性變數之關聯。
研究之實證結果顯示，所得確實為影響癌症死亡率及醫療利用率之重要因素，所得愈高死亡率愈低，所得愈高醫療利用亦愈少，呈顯著負相關。性別對肝癌患者之死亡率及醫療利用率均呈顯著正相關；年齡則對肺癌之醫療利用率呈顯著正相關；癌症患者之醫療利用率隨時間經過，亦呈顯著正相關，與原預期醫療利用隨著時間推移逐漸成長之趨勢一致。

關鍵字

存活率 ； 醫療利用 ； 所得

並列摘要

This article aims to explore the association of income and cancer mortality and medical utilization rates. This article was using the National Health Insurance database from 1996 to 2008, through the underwriting files, outpatient cost files, the cost of hospitalization files, and serious injury files, screening those who participated in the Civil Servant Insurance and suffered from liver cancer, lung cancer or gastric cancer patients data to explore the 1-year, 2-year, 3-year mortality rates affected by the patients'' personal income and other variables of characteristics. The objective of the study was to evaluate the degree of personal income and other variables of characteristics by adopting patients survival at the rate of health care utilization in the period of 1 year, 2 years, 3 years. This article submitted by using the model of Probit and OLS as an empirical model to construct the mortality rate of cancer patients and health care utilization related with income and personal characteristics variables.
The empirical results of this study showed that income is indeed an important factor in cancer mortality and health care utilization rates; the higher income the lower mortality and health care utilization, so it showed a negative correlation. While gender on mortality rates and health care utilization of patients with liver cancer showed a positive correlation; age on health care utilization rate of lung cancer showed a positive correlation; the time for cancer patients on health care utilization rate also showed a positive correlation, in accordance with the trends of health care utilization growing over time.

並列關鍵字

survival rate ； health care utilization ； income

參考文獻

8.翁瑞宏（2000）「全民健康保險中醫門診醫療利用之研究」，中國醫藥學院醫務管理研究所碩士班論文。

13.湯澡薰、郭乃文和張維容（2002）「全民健保醫療服務使用公平性之探討」，醫護科技期刊，第4卷，第4期，291-303頁。

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