應用吉尼係數於臺灣地區醫療資源之均等性分析

To Apply Gini Coefficient for Studying the Equity of Medical Resource in Taiwan

張炳華(Bin-Wha Chang) ； 陳彥臻(Yan-Chen Chen) ； 馮兆康(Chao-Kang Feng) ； 李怡慶(Yii-Ching Lee)

《管理實務與理論研究》 14卷2期 (2020/12) Pp. 74-89

https://doi.org/10.29916/JMPP.202012_14(2).0005

摘要

背景：台灣地區隨著人口年齡結構的高齡化以及各種文明疾病的激增，使得醫療資源的需求越來越高。因此，如何適切的分配醫療資源，提升醫療照護的效率，便成為政府施政的重點工作之一。目的：探討臺灣地區各縣市醫療資源配置之均等性，並進行各縣市醫療資源的差異性分析。方法：本研究採用次級資料分析，資料來源以政府公開之數據資料庫為主，資料庫包含有衛生福利部統計處、統計資訊網與內政部戶政司資料庫，資料收集年份為2007年、2012年及2017年。研究對象為臺灣地區20個縣市，研究分析採用Power BI、羅倫茲曲線和吉尼係數進行醫療資源分配分析。結果：本研究結果顯示在醫療資源均等性的分析上，各縣市區域的醫療資源分配不均的現象仍然存在。若依地理面積大小評估，雖然地理面積與醫療資源多寡並不能代表絕對的關係，但區域間之醫療資源確有顯著差異。另以羅倫茲曲線和吉尼係數，分析醫療資源的人口與土地面積的均等性，結果顯示以人口分布為基礎的醫療資源分配遠較於以土地分布為基礎的醫療資源分配均等。結論：分析醫療資源的均等性，發現台灣地區醫療資源顯著性集中在部分區域，導致偏鄉地區醫療資源不足。同時發現臺灣地區各縣市醫療資源配置不平衡的現象仍長年存在，且影響各縣市醫療資源之利用效率。建議:基於本研究之結果，建議衛生主管機關應積極設法增加各種醫療資源，甚至提高機構設置之誘因或補助，鼓勵醫療人員投入偏鄉服務，以補足城鄉醫療資源失衡之缺口。

關鍵字

醫療資源 ； 均等性 ； 羅倫茲曲線 ； 吉尼係數

並列摘要

Background: With the structure of aging people changed in Taiwan and the increasing of various civilization diseases rapidly, the demand of medical resources is increasing. Therefore, how to properly allocate medical resources (MRs) and improve the efficiency of medical care, it has become a key issue and work to the government. Purpose: To study the equity of MRs and their differences among counties and cities in Taiwan. Methods: This study used secondary data analysis, and the data sources are mainly from government-published databases e.g., Ministry of Health and Welfare, Statistical Information Network, and Ministry of the Interior. The collection years of data are year 2007, 2012, and 2017. Twenty counties and cities in Taiwan were studied. Regarding the tool of analysis on equivalence (MRE), we used Power BI, Lorentz curve and Gini coefficient. Results: In the analysis of MRE, the result showed that existed an uneven distribution of MRs in studied cases, and based on the data of geographic area; MRs didn't show an absolute relationship with area of counties that was a significant difference among counties. Moreover, the results of Lorenz curve and the Gini coefficient analysis also showed that the distribution of MRs based on population was much more equal than MRs based on area size. Conclusions: To analyze the MRE, it revealed the significance difference and this difference resulted the concentration of MRs in some specific areas, for example in some rural areas they were with insufficient MRs. Suggestion: Therefore, by this study result, it recommends that health authorities should actively try to increase various MRs such as physicians, nurses, administrative staffs, equipment and budgets, and even to increase the incentives or subsidies for the establishment of institutions to shorten the gap between urban and rural areas. Finally, for counties and cities with low utilization of MRs, this study recommends to proper adjust the allocation of MR according to the real needs of local medical services, and to improve their utilization on medical services.

並列關鍵字

Medical resource ； Equivalent ； Lorentz curve ； Gini coefficient

參考文獻

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