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題名：衛生資源配置策略--國際發展及對臺灣的啟示
書刊名：臺灣公共衛生雜誌
作者：梁玲郁／黃旭明／藍忠孚
作者(外文)：Liang, Ling-yu／Huang, Shiuh-ming／Lan, Chung-fu
出版日期：2004
卷期：23:4
頁次：頁282-291
主題關鍵詞：衛生資源配置；疾病負擔；健康綜合測量；失能調整人年；公平；Health resource allocation；GBD；Global burden disease；DALYs；Disability-adjusted life years；SMPH；Summary measures population health；Equity
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(2) 博士論文(1) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:22
  • 點閱點閱:96
　　　　　背景：衛生資源配置雖不是新議題，但在政府財務愈趨緊縮與貧富不均日益嚴重的情況下，此議題日趨重要。決策者需尋求所有可資運用的模式，將有限資源做更有效的配置與應用。目的：本文乃回顧衛生資源配置之基本理論，並探討近年來國際間再度興起之健康綜合測量的原理方法及其應用，亦分析比較各種評估方法之差異，用以探究臺灣現況與問題，並對未來資源配置提出具體可行的建構方向。結論：臺灣目前衛生資源配置仍有相當改善的空間。配置原則除了以各類疾病別、性別及年齡別的流行病學資料為基礎，發展本土化全國疾病負擔外，同時考量實際醫療費用支出、健康公平性原則，與方案執行的可行性，提出衛生資源配置的架構。為促進資源使用效率，以厚植民眾健康，運用模式能因時制宜，做動態的應變，才能隨時達成全民最大的期望。
　　　　　Background: Issues in Health Resource Allocation (HRA) are not new but are of growing importance. The increasing demands for health care has led policy makers to address this issue more directly than in the past, facing limited government funding and the widening gap between the rich and the poor. Objectives: Fundamental HRA theories are reviewed in this paper. The paper presents the current trend for the summary measures of population health and the methodology used in health outcome measurement. It compares analyses among different evaluation approaches and also evaluates the current government HRA strategies and specifically proposes an outline of HRA for Taiwan. Conclusions: Health care reform is a continuous undertaking. This research developed a modified Global Burden Disease method for the HRA utilizing national epidemiologic data as well as the national health insurance data for Taiwan. This HRA tool shall be modified dynamically over time and with changing locations in order to achieve both efficiency and equity in its application.
期刊論文
1.Wagstaff, A.、van Doorslaer, E.、van der Berg, H.、Calonge, S.、Christiansen, T.、Citoni, G.(1999)。Equity in the Finance of Health Care:Some Further International Comparisons。Journal of Health Economics，18(3)，263-290。  new window
2.張鴻仁、黃信忠、蔣翠蘋(20020600)。全民健保醫療利用集中狀況及高、低使用者特性之探討。臺灣公共衛生雜誌，21(3)，207-213。new window  延伸查詢new window
3.蔡貞慧、周穎政(20021000)。臺灣全民健康保險的醫療支出重分配效果，1995∼2000。臺灣公共衛生雜誌，21(5)，373-379。new window  延伸查詢new window
4.Mathers, C. D.、Sadana, R.、Salomon, J. A.、Murray, C. J. L.、Lopez, A. D.(2001)。Healthy life expectancy in 191 countries, 1999。The Lancet，357(9269)，1685-1691。  new window
5.Lubitz, J.、Beebe, J.、Baker, C.(1995)。Longevity and Medicare Expenditures。The New England Journal of Medicine，332(15)，999-1003。  new window
6.Meier, M.、Felder, S.、Schmitt, H.(2000)。Health Care Expenditure in the Last Months of Life。Journal of Health Economics，19(5)，679-695。  new window
7.Zweifel, P.、Felder, S.、Meiers, M.(1999)。Ageing of Population and Health Care Expenditure: A Red Herring?。Health Economics，8(6)，485-496。  new window
8.Chiang, T. L.(1999)。Economic transition and changing relation between income inequality and mortality in Taiwan: regression analysis。British Medical Journal，319，1162-1165。  new window
9.Murray, C. J. L.、Acharya, A. K.(1997)。Understanding DALYs。J Health Econ，6，703-730。  new window
10.Berk, M. L.、Monheit, A. C.(2001)。The concentration of health care expenditures, revisited。Health Aff，20，9-18。  new window
11.李丞華(2003)。從效率面談臺灣健康體系的再造。臺灣公共衛生雜誌，22(2)，89-96。new window  延伸查詢new window
12.Nord, E.(1999)。Towards cost-value analysis in health care?。Health Care Analysis，7，167-175。  new window
13.Ezzati, M.、Lopez, A. D.、Rodgers, A.、Vander Hoorn, S.、Murray, C.(2002)。Selected major risk factors and global and regional burden of disease。Lancet，360，1351-1360。  new window
14.Hyder, A. A.、Rotllant, G.、Morrow, R. H.(1998)。Measuring the Burden of Disease: Healthy Life-years。American Journal of Public Health，88(2)，196-202。  new window
15.Gold, M. R.、Stevenson, D.、Fryback, D. G.(2002)。HALYs and QALYs and DALYs, oh my: Similarities and differences in Summary measures of population health。Annu Rev Public Health，23，112-134。  new window
16.Macinko, J. A.、Starfield, B.(2002)。Annotated Bibliography on equity in health, 1980-2001。Int J Equity Health，1，1-20。  new window
17.Van Doorslaer, V.、Wagstaff, A.、Van Der Burg, H.、Van, Doorslaer E.、Van Der, Burg H.(2000)。Equity in the Delivery of Health Care in Europe and the US。Journal of Health Economics，19，553-583。  new window
18.Wagstaff, A.(2002)。Reflections on and alternatives to WHO's fairness of financial contribution index。Health Econ，11，103-115。  new window
19.Subramanian, S. V.、Belli, P.、Kawachi, I.(2002)。The macroeconomic determinants of health。Annu Rev Public Health，23，287-302。  new window
20.Ham, C.(1997)。Priority setting in health care: Learning from international experience。Health Policy，42，49-66。  new window
21.Barendregt, J. J.、Bonneux, L.、Van Der Maas, P. J.(1996)。DALYs: The age-weights on balance。Bull WHO，74，439-443。  new window
22.Murray, C. J.、Lopez, A. D.(1996)。The Incremental Effect of Age-weighting on YLLs, YLDs, and DALYs: A Response。Bulletin of the World Health Organization，74(4)，445-446。  new window
23.Tsuchiya, A.(1999)。Age-related Preferences and Age Weighting Health Benefits。Soc Sci Med，48，267-276。  new window
24.Ustun, T. B.、Rehm, J.、Chatterji, S.、Saxena, S.、Trotter, R.、Room, R.、Bickenbach, J.(1999)。Multiple-informant Ranking of the Disabling Effects of Different Health Conditions in 14 Countries: WHO/ NIH Joint Project CAR Study Group。Lancet，354(9173)，111-115。  new window
25.Vasudevan, S. V.(1996)。Role of functional capacity assessment and disability evaluation。J Back Musculoskelet，6，237-248。  new window
26.Huskamp, H. A.、Newhouse, J. P.(1999)。Future directions for the national health accounts。Health Care Financing Review，21，5-13。  new window
27.Musgrove, P.、Zeramdini, R.、Carrin, G.(2002)。Basic patterns in national health expenditure。Bull WHO，80，134-142。  new window
28.Seahamani, M.、Gray, A.(2002)。The impact of ageing on expenditures in the National Health Service。Age and Ageing，31，287-294。  new window
29.O'Neill, C.、Groom, L.、Avery, A. J.、Boot, D.、Thornhill, K.(2000)。Age and proximity to death as predictors of GP care costs: Results from a study of nursing home patients。Health Econ，9，733-738。  new window
30.Tepper, S.、Sutton, J.、Beatty, P.、DeJong, G.(1997)。Alternative definitions of disability: Relationship to health-care expenditures。Disabil Rehabil，19，556-558。  new window
31.Emanuel, E. J.、Emanuel, L. L.(1994)。The economics of dying - The illusion of cost savings at the end of life。The New England Journal of Medicine，330，540-544。  new window
32.Lubitz, J.、Cai, L.、Kramarow, E.、Lentzner, H.(2003)。Health, life expectancy, and health care spending among the elderly。The New England Journal of Medicine，349(11)，1048-1055。  new window
33.Gross, C. P.、Anderson, G. F.、Powe, N. R.(1999)。The relation between funding by the national institutes of health and the burden of disease。The New England Journal of Medicine，340，1881-1886。  new window
會議論文
1.行政院衛生署(2002)。建構全民健康保醫療決策之統計支援系統模式－URI為例之統計分析架構。沒有紀錄。  延伸查詢new window
研究報告
1.藍忠孚、梁玲郁(2001)。實證基礎之健康優先次序訂定－DALYs之應用。沒有紀錄。  延伸查詢new window
2.李奕慧、梁玲郁(2002)。病人基礎之衛生指標建立－DALE之應用。沒有紀錄。  延伸查詢new window
3.Mathers, C. D.、Sadana, R.、Salomon, J. A.、Murray, C. J.、Lopez, A. D.(2000)。Estimates of DALE for 191 Countries: Methods and Results。Geneva, Switzerland。  new window
圖書
1.Murray, C. J. L.、Lopez, A. D.(1996)。The Global Burden of Disease。World Health Organization。  new window
2.Spilker, B.(1996)。Quality of Life and Pharmaco-economics in Clinical Trials。Philadelphia, PA：Lippincott-Raven。  new window
3.Santerre, Rexford E.、Neun, Stephen P.(1996)。Health Economics: Theories, Insights, and Industry Studies。Health Economics: Theories, Insights, and Industry Studies。Burr Ridge, IL：Irwin。  new window
4.Patrick, Donald L.、Erickson, Pennifer(1993)。Health status and health policy: Quality of life in health care evaluation and resource allocation。New York：Oxford University Press。  new window
5.(2002)。Summary Measures of Population Health: Concepts, Ethics, Measurement and Applications。Summary Measures of Population Health: Concepts, Ethics, Measurement and Applications。Geneva, Switzerland。  new window
6.World Health Organization(1999)。World Health Report 1999。World Health Report 1999。Geneva, Switzerland。  new window
7.World Health Organization(2000)。World Health Report 2000。World Health Report 2000。Geneva, Switzerland。  new window
8.World Health Organization(2002)。The 10/ 90 Report on Health Research 2001-2002。The 10/ 90 Report on Health Research 2001-2002。Geneva, Switzerland。  new window
9.Drumond, M. F.、O'Brien, B. J.、Stoddart, G. L.、Torrance, G. W.(1997)。Methods for the Economics Evaluation of Health Care Programmes。Methods for the Economics Evaluation of Health Care Programmes。NY。  new window
10.Chiang, C. L.(1965)。An Index of Health: Mathematical Models。An Index of Health: Mathematical Models。Washington, DC。  new window
11.World Health Organization(2001)。National Burden of Disease Studies: A Practical Guide。National Burden of Disease Studies: A Practical Guide。Geneva, Switzerland。  new window
12.Global Equity Gauge Alliance(2003)。The Equity Gauge-Concepts, Principle and Guidelines: A Guide for Social and Policy Change in Health。The Equity Gauge-Concepts, Principle and Guidelines: A Guide for Social and Policy Change in Health。South Africa。  new window
13.行政院衛生署(2002)。國民醫療保健支出。國民醫療保健支出。臺北。  延伸查詢new window
其他
1.中央健康保險局(1999)。全民健康保險統計，沒有紀錄。  延伸查詢new window
 
 
 
 
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