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題名:長期照護機構住民醫療利用分析--以中部四縣市為例
書刊名:臺灣公共衛生雜誌
作者:陳雪姝蔡淑鈴黃欽印
作者(外文):Chen, Sheue-shuTsai, Shu-lingHuang, Chin-yin
出版日期:2009
卷期:28:3
頁次:頁175-183
主題關鍵詞:長期照護醫療利用固定影響Long-term careMedical care utilizationFixed effect
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(5) 博士論文(2) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:5
  • 共同引用共同引用:3
  • 點閱點閱:98
目標:人口老化所衍生之老人醫療照護在台灣已是迫切之問題。本研究的目標在分析台灣長期照護機構與非機構(社區)內老人全民健保醫療利用之現況與差異。方法:本研究為實驗對照研究,以1:1隨機配對方式選取與實驗組相同控制變項(含基本特性、疾病種類與疾病嚴重度等)之老人為對照組。在扣除對照組之固定影響(fixed effect),計算出兩組醫療利用之差異。結果:以每人年門住診平均醫療利用而言,機構組之全民健保醫療費用較非機構組高出18%,達統計上顯著性差異;又收容疾病嚴重度較高之護理之家組,較非機構組之全民健保醫療利用差距仍高,差距縮小至12%,但未達統計上顯著性差異。結論:長期照護機構老人住民醫療利用,在全民健保醫療給付之誘因下,確存在較高之利用率,其中可能隱含供給誘發需求。未來台灣人口將快速老化,相關機關應及早規劃長期照護保險之財務與給付制度,以使全民健保的醫療功能更臻完善。
Objectives: The purpose of this research was to investigate differences in medical care utilization between elderly residents of long-term-care organizations and community residents under the National Health Insurance (NHI) program in Taiwan. Methods: A case-control study design using the fixed-effects model was employed. The experimental group was made up of elderly residents of long-term-care organizations. In order to obtain a precise estimate and control for possible confounding variables, the individual random matching method was used to select the community residents who made up the control group on the controlling variables (i.e., age, sex, disease severity, specific diseases, etc.). Results: The average rate of medical care utilization of the experimental group was 18% higher than that of the control group; this difference was statistically significant. Surprisingly, the average rate of medical care utilization of nursing-home residents was only 12% higher than that of the community residents, with no statistically significant difference between the two test groups. Conclusions: Supply-induced demand may exist in the medical care utilization of long-term-care organizations under the NHI program. The study results are important for planning long-term-care insurance programs to meet the requirements of the aging population of Taiwan.
期刊論文
1.Cuellar, Alison E.、Wiener, Joshua M.(2000)。Can Social Insurance for Long-Term Care Work? The Experience of Germany。Health Affairs,19(3),8-25。  new window
2.吳淑瓊(20051200)。人口老化與長期照護政策。國家政策季刊,4(4),5-24。  延伸查詢new window
3.Fuchs RV(1999)。Health care for the elderly how much? Whowill pay for it?。Health Aff,18,11-21。  new window
4.Hu YH, Wang SS, Kuo SC.(1995)。Home care for disabled elderly: an integration of quantitative research。Public Health Quarterly,22,99-113。  new window
5.黃源協(2005)。區長期照護體系的建構。國家政策季刊,4,41-68。  延伸查詢new window
6.Ramroth H, Specht-Leible N, Brenner H.(2005)。Hospitalizations before and after nursing home admission: a retrospective cohort study from Germany。Age Ageing,34,291-294。  new window
7.Pell J, Williams S.(1999)。Do nursing home residents make greater demands on GPs? A prospective comparative study。Br J Gen Pract,49,527-530。  new window
8.Wilson D, Truman C.(2005)。Comparing the health service sutilization of long-term-care residents, homecare recipients, and the well elderly。Can J Nurs Res,37,139-154。  new window
9.Grabowski DC.(2008)。The market for long-term care services。Inquiry,45,58-74。  new window
10.Grabowski DC, Gruber J.(2007)。Moral hazard in nursing home use。J Health Econ,26,560-577。  new window
11.Mor V, Zinn J, Gozalo P, Feng Z, Intrator O, Grabowski DC.(2007)。Prospects for transferring nursing home residents to the community。Health Aff,26,1762-1771。  new window
研究報告
1.劉麗雯(2002)。老人長期照護機構網絡建立之評估研究。  延伸查詢new window
學位論文
1.黃凱琳(2004)。住入護理之家前後住民醫療資源枆用之比較(碩士論文)。高雄醫學大學。  延伸查詢new window
2.康勝傑(2006)。接受長期照護服務老人之健保資源利用分析(碩士論文)。國防醫學院。  延伸查詢new window
3.蘇淑貞(2001)。台灣地區護理之家服務現況之探討(碩士論文)。台北醫學院,台北。  延伸查詢new window
4.張立功(1997)。不同型態長期照護機構成本效益--效果之比較研究(碩士論文)。高雄醫學院。  延伸查詢new window
5.范淑玲(2004)。護理之家住民長期照護服務使用情形及其相關因素探討(碩士論文)。國立陽明大學。  延伸查詢new window
6.林四海(2006)。台灣地區長期照護機構老人醫療利用之研究--長期照護與全民健康保險臨界服務之界定(博士論文)。國立中正大學。new window  延伸查詢new window
7.范涵惠(2002)。長期照護機構老人健康狀況、生活適應及生活滿意度相關性之探討(碩士論文)。中國醫藥學院。  延伸查詢new window
圖書
1.盧瑞芬、謝啟瑞(2000)。醫療經濟學。學富文化事業有限公司。  延伸查詢new window
2.行政院衞生署(97)。統計資料,衞生統計系列(4)全民健康保險醫療統計。95年度全民健康保險醫療統計年報。  延伸查詢new window
3.Grabowski DC, Feng Z, Intrator O, Mor V.(2004)。Recenttrends in state nursing home payment policies.。Health Aff。  new window
 
 
 
 
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