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題名：健康行為群聚類別與醫療利用之關係--以臺灣成年初顯期族群為例
書刊名：臺灣公共衛生雜誌
作者：葉昱佐／施淑芳 引用關係
作者(外文)：Yeh, Yu-tso／Shih, Shu-fang
出版日期：2014
卷期：33:6
頁次：頁649-662
主題關鍵詞：成年初顯期；健康行為；群聚分析；醫療利用；Emerging adulthood；Health behaviors；Cluster analysis；Healthcare utilization
原始連結：連回原系統網址new window
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目標：探討18～25歲成年初顯期族群健康行為群聚類別與醫療利用之相關性。方法：本研究使用2009年國民健康訪問調查，以18～25成年初顯期族群為研究對象，運用二階段群聚分析法依健康行為型態進行群聚分析，並使用羅吉斯迴歸及零膨脹負二項迴歸模型分析群聚類別與急診及西醫門診醫療利用與否及醫療利用次數之相關性。結果：成年初顯期族群可分為「菸酒不離族」、「飲食不均族」以及「健康保健族」三個群聚類別。相較於健康保健族，在急診醫療利用與否方面，菸酒不離族較可能使用到急診醫療（OR=1.59; 95% CI=1.14-2.21）；在急診醫療利用次數方面，飲食不均族使用較多次數的急診醫療（IRR=1.49; 95% CI=1.08-2.05）；群聚類別與西醫門診利用與否或其利用次數則無統計顯著相關。結論：成年初顯期健康行為具有群聚之現象且群聚類別與急診醫療利用之機率與急診使用次數有統計顯著相關。未來不管是學校或職場健康促進方案，可針對具有共同健康行為特性之成年初顯期族群，規劃整合及客制化之介入方案。
Objectives: This study aims to investigate the association between clustering of healthrelated behavirs and heathcare services utilization amongst emerging adults. Methods: This study utilized a sub-sample between 18 and 25 years of age from the 2009 National Health Interview Survey. A two-step cluster analysis was used to identify groups of emerging adults with similar behavior patterns. Logistic regression and a zero-inflated negative binomial regression model were used to determine the association between groups of clustering and utilization of emergency care and outpatient healthcare services. Results: Three clusters were identified, including ＂smokingalcohol,＂ ＂unbalanced diet,＂ and ＂healthy lifestyle.＂ Those who were classified in the ＂smokingalcohol＂ cluster were more likely to use emergency care services (OR=1.59; 95% CI=1.14-2.21), and those who were in the ＂unbalanced diet＂ cluster were more likely to use emergency care service (IRR=1.49; 95% CI=1.08-2.05) when compared to those in the ＂healthy lifestyle＂ cluster. The current study showed no relationship between the clusters and outpatient healthcare services, whether or not use or the number of visits was considered. Conclusions: Health-related behaviors tend to cluster amongst emerging adults. In addition, health behavior clusters were shown to be associated with a higher risk of using emergency care and more visits of emergency care services. These findings suggest that whether school- or workplace-based, health promotion program could adopt an integrated approach and taior-made programs, when taking into account the common determinants across different types of health behaviors.
期刊論文
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15.Busch, V.、van Stel, H. F.、Schrijvers, A. J.、de Leeuw, J. R.(2013)。Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study。BMC Public Health，13，1118。  new window
16.Hagoel, L.、Ore, L.、Neter, E.、Silman, Z.、Rennert, G.(2002)。Clustering women's health behaviors。Health Educ Behav，29，170-182。  new window
17.Sari, N.(2009)。Physical inactivity and its impact on healthcare utilization。Health Econ，18，885-901。  new window
18.Zhang, J.、Chaaban, J.(2013)。The economic cost of physical inactivity in China。Prev Med，56，75-78。  new window
19.Lin, T. F.(2008)。Modifiable health risk factors and medical expenditures-the case of Taiwan。Soc Sci Med，67，1727-1736。  new window
20.Pope, C. R.(1982)。Life-styles, health status and medical care utilization。Med Care，20，402-413。  new window
21.盧龍泉、陳盈芳、黃姵禎、蔡青姿(20041200)。菸、酒、檳榔消費行為組合與醫療利用率關係之研究。環境與管理研究，5(2)，1-22。new window  延伸查詢new window
22.李秋娓、黃怡婷、顏君瑋(20081200)。大學新生健康問題及健康缺點分析研究。學校衛生，53，1-15。  延伸查詢new window
23.Schuit, A. J.、van Loon, A. J.、Tijhuis, M.、Ocké, M.(2002)。Clustering of lifestyle risk factors in a general adult population。Preventive Medicine，35(3)，219-224。  new window
24.Yen, L. L.、Chiu, C. J.、Wu, W. C.、Pan, L. Y.(2006)。Aggregation of health behaviors among fourth graders in northern Taiwan。Journal of Adolescent Health，39(3)，435-442。  new window
25.劉美媛、呂昌明(20060600)。大一學生健康行為現況及其相關因素之研究--以北部某大學學生為例。學校衛生，48，19-37。  延伸查詢new window
26.陳富莉、李蘭(20010400)。臺灣地區不同年齡層民眾的健康行為聚集型態。公共衛生，28(1)，37-47。  延伸查詢new window
27.丁志音、江東亮(19960600)。以健康行為型態分類臺灣地區之成年人口群--群聚分析之應用。中華公共衛生雜誌，15(3)，175-187。new window  延伸查詢new window
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研究報告
1.衛生福利部國民健康署、國家衛生研究院。2009年「國民健康訪問暨藥物濫用調查」結果報告。  延伸查詢new window
學位論文
1.許軒豪(2007)。健康相關行為型態集群與醫療資源利用--以臺灣地區十八歲以上成人為例(碩士論文)。亞洲大學，臺中。  延伸查詢new window
圖書
1.Arnett, J. J.(2004)。Emerging Adulthood: The Winding Road from the Late Teens through the Twenties。Oxford University Press。  new window
 
 
 
 
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