社區民眾健康行為與醫療利用行為調查分析─子計劃1：社區民眾醫療與預防保健服務之利用行為分析

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Title:	社區民眾健康行為與醫療利用行為調查分析─子計劃1：社區民眾醫療與預防保健服務之利用行為分析
Authors:	林為森
Contributors:	醫務管理系
Keywords:	中老年人醫療利用預防保健利用 the mid-age and elderly population medical resources
Date:	2004
Issue Date:	2008-06-24 11:52:29 (UTC+8)
Publisher:	台南縣：嘉南藥理科技大學醫務管理系
Abstract:	人口結構的快速老化使得醫療照護服務需求與醫療保健支出急劇增加，而社會型態與生活習慣的轉變，也使得疾病型態逐漸以慢性病為主，而且罹患慢性病的年齡也有逐年下降趨勢，為了減少醫療資源的耗用與維護國人健康，瞭解社區民眾的醫療利用及預防保健服務利用行為以及探討影響其行為之相關因素是非常重要的課題。本計劃利用九十年台灣地區國民健康訪問調查資料，統計分析四十歲以上中老年民眾醫療及預防保健服務的利用情形，並比較有無罹患慢性病在醫療及預防保健服務的利用上的差異性。結果發現四十歲以上受訪者由醫護人員認定告知的六大慢性病罹患率分別為：心臟病11.8 ﹪、肺部疾病7.6﹪、高血壓23.1﹪、糖尿病 9.1﹪、高血脂16.8﹪與中風3.2﹪。在醫療利用情形方面，當四十歲以上中老年覺得身體不舒服時較常會做的處理方式是看西醫（84.0﹪）且西醫門診的利用比例（45.9﹪）最高。民俗療法的治療則以以推拿的平均次數較多。在預防保健服務利用方面，受訪者做過血壓測量（71.8﹪）最多，空腹血糖值檢驗、飯後血糖值檢驗，血脂肪檢驗與肝功能檢查的檢查比例均低於50﹪。21.9﹪有接受全身性的健康檢查，其中57.8﹪的費用是由健保支付，超過八成的受訪者（88.4﹪）未接受流行性感冒疫苗預防注射。有無慢性病的差異比較，結果發現除了高血壓與糖尿病與性別無關之外，其餘慢性病均與性別有顯著關聯。慢性病的平均年齡均顯著的高於無慢性病患者。當慢性病患者身體不舒服時較會去看醫師，以看西醫居多。過去一年住院、急診的比例慢性病患均較無慢性病患者高。在西醫門診方面，慢性病患的求診比例均較高；在中醫門診方面，糖尿病、高血脂與中風病患的求診比例無顯著的差異。在預防保健服務利用方面，慢性病患有進行血壓、血糖、血脂肪與肝功能檢查的比例明顯較低；雖然慢性病患者在全身健康檢查與接受流行性感冒疫苗預防注射方面較無慢性病患者佳，但是在慢性病的罹患族群中沒有進行全身健康檢查與接受流行性感冒疫苗預防注射的比例卻較高，顯示慢性病患者的預防保健工作與輔導策略仍需加強。整體而言，四十歲以上中老年人是醫療利用與預防保健利用的主要族群，而罹患六大慢性病之四十歲以上民眾又是醫療與預防保健資源最主要的使用者，因此發展並建立慢性病的疾病追蹤監測、有效推廣預防保健觀念與醫療資源的合理分配均是未來衛生政策需要發展的重點。 The increase of the elderly population and chronic disease cases makes the medical expense rapidly growing. In order to reduce waste of medical resources and maintain personal health, it is important to understand how the mid-aged and elderly population uses medical and preventative health resources. The purpose of this study is to analyze data of the health survey in 2001 and exam the mid-aged and elder people’s（≧40 years） behaviors using medical and preventative resources. Results showed chronic disease rates in this population were 11.8﹪with heart disease, 7.6﹪with lung disease, 23.1﹪with hypertension, 9.1﹪with diabetes、16.8﹪with hyperlipemia and 3.2﹪with stroke. 84.0﹪of the mid-aged and elderly population went to see doctors when they were sick and 45.9﹪ preferred going to medical clinics. People with chronic diseases used more hospitalization, emergency services, clinical services including Chinese medicine, but there were some differences among different types of chronic diseases. People with chronic diseases had less physical examinations including blood pressure, blood sugar, cholesterol, triglycerides and liver function. A proportion of the elderly population receiving the total physical examination and the flu vaccine was still low. Planning of medical and health preventative resources for the mid-aged and elderly population should be improved and emphasized in the health policy to maintain their health.
Relation:	計畫編號：CNHA9303_1
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Chna Project

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