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題名:臺灣醫療資源使用之公平性探討
書刊名:醫護科技學刊
作者:湯澡薰郭乃文葉壽山
作者(外文):Tang, Chao-hsiunKuo, Nai-wenYeh, Shou-shan
出版日期:1999
卷期:1:1
頁次:頁43-58
主題關鍵詞:JEL分類代號公平性醫療資源使用JEL classificationEquity in health care deliveryHealth care utilization
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(3) 博士論文(0) 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:0
  • 點閱點閱:19
     本研究使用1991年醫療保健支出調查資料以負二項跨越模型與零轉換負二項模型 以檢定在臺灣的醫療保健提供制度在全民健保實施前是否存在水平的不公平;如果有的話, 本文進一步衡量其不公平的程度的幅度,其結果可作為往後討論全民健保對醫療資源之公平 性影響之參考基準。 本文以西醫門診就醫次數來代表使用醫療資源的多寡,以自覺身體狀況、年齡與性別來解釋 對醫療資源需要程度的差異,另外,除了所得之外,其他社經變數如教育水準、婚姻狀態與 家戶大小也納入分析中。 本研究迴歸分析結果拒絕了臺灣醫療保健提供制度沒有水平不公平存在的虛無假設。雖然在 控制了其他變因之下,自覺健康狀況與門診次數的多寡存在有正向關係,印證了垂直公平性 的存在一對醫療資源需要程度愈高者,得到愈多的醫療資源。然而社經地位變數,如家庭所 得、教育水準與婚姻狀態,都對西醫門診的使用有顯著的影響,表示臺灣醫療保健提供制度 在全民健保實施前存在有與社經地位相關的水平不公平性存在。 非工作所得每增加 1%,就 醫次數便增加 0.5%。 教育水準愈高,就醫次數也愈高。單身比已婚有偶的人之就醫次數少 1.66 次,但離婚╱喪偶者也比已婚有偶者之就醫次數高出 1.20。女性平均而言比男性之就 醫次數高了 1.41 次。
     This study employs data from Taiwan's 1992 National Health Care Expenditure Survey to test the null hypothesis of no horizontal inequity in delivery of health care. The tests are based on hurdle models and zero-altered models that include several socioeconomic variables, such as family income, education and marital status. The empirical results rejects the hypothesis of no inequity because socioeconomic variables exhibit significant effect on the utilization of outpatient visits. An 1% increase in family income raises the number of outpatient visits for 0.5%. The higher the education one received, the more he/she uses the outpatient services. On the average, single individuals seek 1.66 less visits than married individuals, while the divorced/bereaved persons have 1.20 more visits than the married people.
期刊論文
1.Davis, Karen、Reynolds, Roger(1975)。Medicare and the utilization of health care services by the elderly。Journal of Human Resources,10,361-377。  new window
2.Le Grand, J.(1978)。The distribution of public expenditure: the case of health care。Economica,45,125-142。  new window
3.Collins, E.、Klein, K.(1980)。Equity and the NHS: self-reported morbidity, access and primary care。British Medical Journal,281,1111-1115。  new window
4.Link, Charles R.、Long, S. H.、Settle, R. F.(1982)。Equity and the utilization of health care services by the medicare elderly。Journal of Human Resources,17,195-212。  new window
5.Duan, N.、Manning, W. G.、Morris, C. N.、Newhouse, J. P.(1983)。A comparison of alternative models for the demand for medical care。Journal of Business and Economic Statistics,1,115-126。  new window
6.Mullahy, John(1986)。Specification and testing of some modified count data models。Journal of Econometrics,33,341-365。  new window
7.O'Donnell, Owen、Propper, Carol(1991)。Equity and the distribution of UK national health services resources。Journal of Health Economics,10,1-19。  new window
8.Wagstaff, Adam、van Doorslaer, E.、Paci, P.(1991)。On the measurement of horizontal inequity in the delivery of health care。Journal of Health Economics,10,169-205。  new window
9.Lambert, Diane(1992)。Zero-inflated poisson regression, with an application on defects in manufacturing。Technometrics,34(1),1-14。  new window
10.van Doorslaer, Eddy、Wagstaff, Adam(1992)。Equity in the delivery of health care: some international comparisons。Journal of Health Economics,11,389-411。  new window
11.Williams, Alan(1993)。Priorities and research strategy in health economics for the 1990s。Health Economics,2,295-302。  new window
12.Pohlmeier, Winfried、Ulrich, Volker(1995)。An econometric model of the two-part decision-making process in the demand for health care。Journal of Human Resources,30,339-361。  new window
13.Mooney, Gavin(1996)。And now for vertical equity? some concerns arising from aboriginal health in Australia。Health Economics,5,99-103。  new window
14.Gerdtham, U. G.(1997)。Equity in health care utilization: further tests based on hurdle models and Swedish micro data。Health Economics,6,303-319。  new window
15.Mooney, Gavin、Jan, Stephen(1997)。Vertical equity: weighting outcomes? or establishing procedures?。Health Policy,39,79-87。  new window
圖書
1.行政院衛生署(1997)。全民健保實施二年評估報告。  延伸查詢new window
2.Le Grand, J.(1982)。The Strategy of Equality: Redistribution and the Social Services。London:Allen & Unwin。  new window
圖書論文
1.Manning, W. G. Jr.、Morris, C. N.、Newhouse, J. P.(1981)。A two-part model of the demand for medical care: preliminary results from the health insurance study。Health, Economics and Health Economics。Amsterdam:North Holland。  new window
2.Wagstaff, Adam、van Doorslaer, Eddy(1993)。Equity in the finance and delivery of health care: concepts and definitions。Equity in the Finance and Delivery of Health Care: An International Perspective。Oxford:Oxford University Press。  new window
3.Wagstaff, A.、van Doorslaer, E.、Paci, P.(1994)。Equity in the finance and delivery of health care: some tentative cross-country comparisons。Providing Health Care: the Economics of Alternative Systems of Finance and Delivery。Oxford:Oxford University Press。  new window
 
 
 
 
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