多比較好？基層醫師供給對可避免住院的影響
-台灣的實證研究

張曉鳳

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多比較好？基層醫師供給對可避免住院的影響 -台灣的實證研究

The more the better? Evidence from the relationship between primary care physicians and preventable hospitalizations in Taiwan context

張曉鳳 , Masters　　Advisor：梁亞文;陳錦杏　　

繁體中文

可近性；可避免住院；門診照護敏感狀況；基層醫師； access ； ACSH ； ambulatory care sensitive conditions ； primary care physician

Abstract │ Reference (128) │ Altmetrics

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Objectives: The first purpose of this study is to describe patterns in ACSHs at the sub-medical regions based on demographics and other characteristics. Secondly, we calculate the ACSH rate for 64 sub-medical regions respectively, using AHRQ definitions.  Last, this study explores the impact of primary care physician supply on ACSH rate in Taiwan.   
Data Sources: Data for this study includes 2000-2006 National Health Research Institute (NHRI) database, a nationally representative dataset, and Taiwan-Fukein Demographic Fact Book from the Ministry of the Interior.  We examine sixteen principal or first-listed diagnoses identified by AHRQ as ACSHs.  The independent variable of interest, the primary care physician supply, is measured as a continuous variable (MDs/10,000). 
Study design:Descriptive statistics are analyzed cross-sectionally and overtime. We take 2000 to 2006 altogether 7 years as research period and 64 sub-medical regions as research samples. Panel data regression model is used to determine the impacts of primary care physician supply on the distribution of ACSHs rate while controlling for other variables may also affect ACSHs. Larrange Multiplier test, Durbin-Watson test and Hausman test are used to test the model.  
Principal Findings: Through 2000 to 2006, ACSH rate for 64 sub-medical regions, respectively showed 0.0003 to 0.047 (Figture-1) The random effect models standardized estimates indicate that, among the measured covariates in our model, physician supply was not associated with ACSH. But, hospital beds and number of people aged under 17 have the positive adjusted relationship with ACSH. 
Conclusions:To improve quality of overall medical service should increase efficiency of primary care system, rather than increases the hospital beds number and care physicians.

Reference ( 128 ) 〈TOP〉

中華民國醫師公會全國聯合會，醫療統計。線上檢索日期：2007年12月30日。網址： http://www.tma.tw/stats/stats_1.asp。
連結：
王馨儀(2006)。氣喘門診照護對可避免住院之影響。(碩士論文，國立台灣大學)。全國碩博士論文資訊網，94NTU05529024。
連結：
史青平(2006)。可避免住院之研究－以闌尾炎破裂或穿孔為例。(碩士論文，國立台灣大學)。全國碩博士論文資訊網，94NTU05529032。
連結：
朱僑麗、薛亞聖與江東亮(2000)。醫師人力供給的多寡是否會影響被保險人的門診利用？－1994年國民醫療保健調查之發現。中華公共衛生雜誌，19(5)，381-388。
連結：
江東亮(1995)。台灣地區的醫師人力政策1945-1994。中華衛誌，14(5)，383-391。
連結：

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