由於民眾醫藥浪費、濫用健保資源的情形越來越嚴重，大小病通通往醫院跑，產生了逛醫院之情形。有鑑於此，健保署為了改善此現象，近幾年來，積極推廣分級醫療政策及「全民健康存摺（My Health Bank）」系統，期盼能避免重複檢驗檢查及提供民眾有效的用藥安全及提升自我健康管理。但健康存摺推廣至今，申請率仍然不高，為了提高民眾申請及下載健康存摺之意願。因此，本研究運用計畫行為理論及現況偏好理論，加上知覺信任構面，進而瞭解有哪些因素會影響使用意願。本研究採問卷調查法，透過與波仕特網路市調公司合作進行問卷發放及收集，研究對象針對年滿20歲以上會員，探討一般民眾對於使用健康存摺於自我健康管理之因素。並以結構方程模式來驗證變數間之因果關係。共發放了320份，其有效問卷為307份，有效回收率有效回收率為95.9%。經本研究結果可得知，影響民眾對於使用健康存摺意圖之關鍵因素，以「態度」、「知覺價值」及「知覺信任」最為顯著（p<0.001）；其次為「知覺行為控制」及「知覺風險」為顯著（p<0.01）；此外，「主觀規範」及「避免後悔」未達顯著影響。本研究之結果，可提供給衛福部和各相關單位作為參考依據，以利有效的推廣健康存摺。建議政府相關單位對於推廣健康存摺時，可以利用醫療院所看板或電視牆，播放介紹健康存摺的好處，亦也可於社區服務民眾時，多加宣傳及推廣。 In recent years, the overexploitation of medical waste and the resources of the national health insurance system have worsened. Regardless of the severity of the disease, people often go to the hospital, which creates a phenomenon known as "hospital shopping." To alleviate this phenomenon, the National Health Insurance Administration Ministry of Health and Welfare actively promoted the “My Health Bank” system to help the people of Taiwan strengthen drug safety and self-management. However, the application rate after the system’s startup remains very low. To investigate this poor implementation rate, we used the theory of planned behavior, the current state of deviation theory, and the perceived confidence dimension to examine variables that may influence people’s willingness to use the system. Our research adopted the questionnaire survey method and cooperated with the Pollster Internet Marketing Company for its distribution and collection. We focused on members older than 20 and on exploring the factors of the general public's use of health passbooks for self-health management. The structural equation model was used to verify the causal relationship between variables. A total of 320 questionnaires were distributed, of which 307 were returned and properly completed; the effective recovery rate was 95.9%. According to the results, the most significant factors affecting the use of My Health Bank were "attitude", "perceived value" and "perceived trust" (p<0.001). Furthermore, "perceived behavior control," and "perceived risk" were significant (p<0.01). However, "subjective norms" and "regret avoidance" was not significant. Together, our results can be provided to the Ministry of Health, and the related units can be used as a reference basis for a more effective promotion of My Health Bank. It is suggested that relevant government units can use the slabs or video walls of medical institutions to promote the benefits of introducing it when promoting My Health Bank. It can also promote the community when serving the public.
