成人預防保健檢查報告異常者之就醫服務利用情形-以雲林縣某地區醫院為例

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Title:	成人預防保健檢查報告異常者之就醫服務利用情形-以雲林縣某地區醫院為例 Use of medical care service among people with abnormal physical examination reports-an example of a regional hospital in Yunlin
Authors:	賴淑玲
Contributors:	醫務管理系(所) 林為森
Keywords:	醫療服務利用健康行為成人健康檢查 Medical utilization Health behaviors Adult preventative physical examination
Date:	2012
Issue Date:	2013-04-22 14:58:48 (UTC+8)
Abstract:	健康檢查是健康促進與健康管理的主要方法，早期診斷早期治療可以預防疾病的發生。本研究目的是為分析健康檢查報告異常者就醫服務利用情形採用次級資料分析，研究對象為2011年8月至2011年12月期間雲林縣某地區醫院接受成人預防保健健康檢查之40歲以上民眾，共248人。利用描述性統計、卡方檢定、獨立樣本t-test及單因子變異數分析等統計方法分析健康檢查報告異常者就醫服務利用情形。　　研究結果發現：研究對象平均年齡67.17歲，女性受檢率大於男性，BMI過重及肥胖者佔50.4%，個人疾病史以高血壓最多佔50.3%，平均每人有1.27種慢性病，超過八成的受檢者有正向的健康習慣行為，檢查報告異常者以血壓測量異常56.9%居多，健康檢查後六個月內平均就診次數4.13次，以高血壓疾患就診次數最多。健康檢查項目異常數，以三種檢查項目異常者居多佔28.23%，平均每人有2.40種檢查項目異常，不同變項與健康檢查異常數無顯著差異。檢查報告異常者其檢查後就醫服務利用次數，在不同年齡、是否長期服藥則達顯著性差異（p <.05），年齡愈高者及有長期服藥者就醫利用次數愈多。　　根據研究結果，建議可將相關的慢性疾病做為醫院健康促進營造與衛教諮詢的主題，政府應參考慢性病流行病學的年齡別盛行率，規劃修正預防保健服務使用上年齡與時程的給付。未來研究者可加入健保政策相關因素變項，以探討就醫利用意願的影響因素。 The physical examination is an important method to promote and manage health. Early diagnosis and treatment can reduce incidences of diseases. The purpose of this study is to analyze the utilization of medical resources for patients with abnormal physical examinations secondary data analysis is used. 248 subjects are from a regional hospital in Yunlin, age over 40, who had adult preventive physical examination from August, 2011 to December, 2011. Descriptive statistics, chi-square test, independent samples t-test and one-way ANOVA analysis are used to analyze the utilization of medical resources for patients with abnormal physical examinations. 　　Results found that the mean age of subjects is 67.17, female examinees hold a higher percentage than male ones. The examining ratio of subjects who are overweigh and obese on the BMI scale is 50.4%. Hypertension(50.3%) is the leading disease of personal medical history. On average, a person has 1.27 kinds of chronic illnesses. Over 80% of examinees have positive health behaviors. Among all the abnormal examination reports, abnormal blood pressure(56.9%) takes the first place, followed by metabolic syndrome(55.6%). Visits of the out-patient department within six months after the physcial examination is 4.13 times, the most cases are hypertensive cases. Most subjects(28.3%)have 3 abnormal physical examination items, and a person has 2.4 abnormal items on average. There is no significant difference between different variables and the number of abnormal examination items. For examinees with abnormal physical examinations, the number of follow-up utilization of medical services have significant statistic differences(p <.05)in different age and taking long-term medication; those with elder age and taking long-term medications have more frequently medical services. 　　According to results we suggest related chronic illnesses should be as a theme issue for health promotion and education in hospitals. The government should consider the influence of age on the prevalence of chronic diseases to adjust the utilization and payment of adult preventive physical examination. We recommend that variables of health insurance policies, should be evaluated in the future study.
Relation:	校內校外均不公開，學年度：100，88頁
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Dissertations and Theses

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