| 摘要: | 近年來臺灣隨著經濟的快速發展，關於醫療的相關議題逐漸被人們所重視。目前，與醫療資源相間研究議題雖不少，但過去研究醫療議題之學科多重於社會學、人類學、經濟學、公共衛生和流行病學或是歷史學等領域之探討，且主要偏重於「人－時－疾病」之間的關係，在「地」的空間概念上之探討則較少。以地理學為著重空間概念的研究學科，早期著重於疾病的探討。
隨著經濟快速發展，一方面醫療技術的進步影響了人在壽命上的延長；另一方面使得人們更重視自己的健康狀況，健康照護成為基本之人權。因此，醫療的可近性(accessibility)與民眾就醫的選擇性也逐漸成為政府單位所重視的施政方向。就醫地理可近性差異，可能導致就醫選擇不同，進而影響治療的內容、品質及結果。全民健保1995年實施後，雖然增加了民眾就醫可近性及弱勢族群的健康照護；然而，一直以來，民眾選擇醫療院所的就醫行為，大致可歸納出「醫院層級、醫療科別、主治醫師」等，就醫院所仍然集中在數間規模較大的醫院。
為了解上述問題，本論文首先建立醫療院所資訊資料庫，藉由各級醫療院所設置區位及空間分佈型態，建立地理資訊系統(Geographic Information System,GIS)查詢網站，能使民眾自己定位所在位置，以縣市、醫院層級、服務科別，快速搜尋適合就醫院所，增加就醫可近性。於系統後端增設1.生理資訊填寫界面，供使用者長常期記錄、觀察自我健康狀態，2.一對一雙向視訊界面與資料上傳界面，供使用者於線上提供健康記錄與可自行選擇醫療人員多方做專業諮詢。本研究未來期許結合遠距醫療照護系統，實踐在地醫療、在地老化、降低醫療成本等目標。
In recent years, with Taiwan's rapid economic development, it is gradually focus on health-related issues. At present, although many medical resources and research topics, but past research subject is focus on multiple medical issues in sociology, anthropology, economics, public health and epidemiology or discussion on the areas of history, and the main focus "person-time-disease" relationship, the discussion on the concept of space is less. The geography-oriented study on the spatial concept of the subject, the former research is focus on disease study.
With the rapid economic development, on the one hand advances in medical technology have affected human life extension; on the other hand, it makes people pay more attention to their health, health care become as basic human rights. Therefore, accessibility of medical care (accessibility) and the populace in pursuit of selective medical unit become the Government's policy direction. Treatment differences in geographical accessibility, may cause choose doctor differently, and affecting the treatment of content, quality, and results. After the implementation of universal health insurance in 1995, while increasing treatment accessibility and disadvantaged groups of the population to health care; however, all along, people select medical institutions of health seeking behavior can be broadly summarized "hospital level, medical divisions, the attending physician" and so on, hospitals remain concentrated in a few large hospitals.
In order to understand these issues, this paper first established hospital information database, through medical institutions at all levels to set location and spatial distribution pattern, establishment of GIS (Geographic Information System,GIS) query site, can make the people themselves to locate location level to County and city governments, hospitals, Services Division fast search for hospitals, increasing treatment accessibility. The additional function of System plateform includs 1. physiological information fill out the interface for users longer recording, observation of self-health status, 2. one-to-one bi-directional video interface and data upload interface, enabling users to online health records and can choose their own medical staff doing professional advisory. Future expectations combined with tele-health care systems in this study, practice in health, aging, reduce medical cost objectives. |
