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題名:全民健保對健康差距之影響--以平均餘命為測量
書刊名:臺灣公共衛生雜誌
作者:吳宛蕙楊長興 引用關係
作者(外文):Wu, Wan-huiYang, Chiang-hsing
出版日期:2007
卷期:26:3
頁次:頁196-207
主題關鍵詞:全民健保平均餘命健康差距都市化時間數列National health insuranceLife expectancyHealth disparityUrbanizationBox and Tiao's event intervention analysis
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(9) 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:9
  • 共同引用共同引用:19
  • 點閱點閱:67
目標:探討全民健保是否有助於改善男性、女性最高與最低都市化,以及最高與中等都市化程度民眾平均餘命之差距。 方法:以1987至2003年為研究期間,使用內政部之人口資料檔及衛生署之死因資料檔,計算出各都市化程度民眾的平均餘命後,採用Box及Tiao的時間數列介入分析,比較全民健保介入民眾平均餘命差距之影響評估。 結果:全民健保實施後,並沒有顯著降低最高、最低都市化位階民眾平均餘命的差距,但是男性最高、中等都市化位階65歲平均餘命差距,以及女性最高、中等都市化位階0歲、5歲、65歲平均餘命差距皆有顯著性的縮小。 結論:全民健保的實施對於民眾的健康有正向的改善,城鄉間女性健康差距較男性小,同時對於最高、中等都市化位階平均餘命差距改善程度優於最高、最低都市化位階平均餘命差距,特別是老年人的部份,但是最高、最低都市化位階民眾平均餘命的差距並沒有顯著性的縮小,因此未來應持續推動最低都市化位階地區民眾婦女保健、產前照護、環境改善及教育提升,使偏遠地區民眾得以獲得適當照顧,進而提升偏遠地區民眾平均餘命,以縮短城鄉間平均餘命的差距。
Objectives: To examine whether National Health Insurance has narrowed the gap of life expectancy between levels of urbanization. Methods: For the period from 1987 to 2003, population data were was obtained from the Taiwan-Fuchien Demographic Fact Book, and cause of death information was obtained from the Department of Health. Life expectancy for residents was transformed to mortality series, and the event intervention analysis by Box and Tiao was employed to compare the disparities in life expectancy among the resident groups. Results: After the implementation of national health insurance in Taiwan, the gap in life expectancy between residents living in areas of the highest and those living in the lowest levels of urbanization was not statistically significantly reduced. For men at age 65, between areas of the highest and the middle levels of urbanization, the lifespan gap was significantly reduced. For females at birth, age 5, and 65, the gap between areas of the highest and middle levels of urbanization was also significantly reduced. Conclusions: Implementation of national health insurance was associated with reduction of health disparities for both genders, although seeming to be more apparent for females than males. The improvement of the gap in life expectancy between residents living in the areas of the highest and middle levels of urbanization was larger than that between the areas of the highest and lowest levels of urbanization, especially for senior citizens. In order to ensure health equity for all citizens, more resources need to be allocated for women’s health care, prenatal care, and environmental protection and education in remote areas.
期刊論文
1.Deaton, Angus(2003)。Health, inequality and economic development。Journal of Economic Literature,41(1),113-158。  new window
2.曾國雄、吳水源(19860300)。臺灣地區市鎮鄉都市化程度特性之研究。國立臺灣師範大學地理研究報告,12,287-323。new window  延伸查詢new window
3.Wen, C. P.、Tsai, S. P.、Shih, Y. T.、Chung, W. S. I.(2004)。Bridging the Gap in Life Expectancy of the Aborigines in Taiwan。International Journal of Epidemiology,33(2),320-327。  new window
4.Balabanova, D.、Mckee, M.、Akingbade, K. P.(2004)。Urban-rural disparities in health and living conditions in the Former Soviet Union: towards a comprehensive regional analysis。Bur J Public Health,14,62-63。  new window
5.溫啟邦、蔡善璞、鍾文慎(20050400)。高雄市和臺北市居民平均餘命差距之分析。臺灣公共衛生雜誌,24(2),125-135。new window  延伸查詢new window
6.羅紀瓊(19950600)。所得重分配 量能來付費--全民健康保險之保費規劃。會計研究月刊,117,42-47。  延伸查詢new window
7.Box, G. E. P.、Tiao, G. C.(1975)。Intervention analysis with applications to economic and environmental problems。Journal of the American Statistical Association,70(349),70-79。  new window
8.Fleming, N. S.、Becker, E. R.(1992)。The impact of the Texas 1989 motorcycle helmet law on total and head-related fatalities, severe injuries, and overall injuries。Medical Care,30,832-845。  new window
9.Ho, P. S.、Wang, T. N.、Hsieh, T. K.、Ko, Y. C.(2000)。Differences in Physician Utilization between Aboriginal and Nonaboriginal Children。Family Practice,17(4),414-421。  new window
10.Dow, W. H.、Schmeer, K. K.(2003)。Health Insurance and Child Mortality in Costa Rica。Social Science & Medicine,57,975-986。  new window
11.Burstrom, K.、Johannesson, M.、Diderichsen, F.(2005)。Increasing Socio-economic Inequalities in Life Expectancy and QALYs Sweden 1980-1997。Health Economics,14,831-850。  new window
12.Kalediene, R.、Petrauskiene, J.(2000)。Inequalities in Life Expectancy in Lithuania by Level of Education。Scandinavian Journal of Public Health,28,4-9。  new window
13.Starkuviene, S.、Petranskiene, J.、Kalediene, R.(2004)。Inequalities in Mortality of Lithuanian Urban and Rural Populations: The Effect of Educational Level。European Journal of Public Health,14,113。  new window
14.Girard, D. Z.(2000)。Intervention Times Series Analysis of Pertussis Vaccination in England and Wales。Health Policy,54,13-25。  new window
15.Dickute, J.、Padaiga, Z.、Gragauskas, V.、Nadisauskiene, R. J.、Basys, V.、Gaizauskiene, A.(2004)。Maternal Socioeconomic Factors and the Risk of Low Birth Weight in Lithuania。Medicina,40,475-482。  new window
16.Shmueli, A.(2004)。Population Health and Income Inequality: New Evidence from Israeli Time-series Analysis。International Journal of Epidemiology,33,311-317。  new window
17.Whitehead, M.、Scott-Samuel, A.、Dahlgren, G.(1998)。Setting Targets to Address Inequalities in Health。The Lancet,351,1279-1282。  new window
18.Vorster, H. H.、Wissing, M. P.、Venter, C. S.(2000)。The Impact of Urbanization on Physical, Physiological and Mental Health of Africans in the Northwest Province of South Africa: The THUSA Study。South African Journal of Science,96,505-514。  new window
19.Zimmer, Z、Martin, L.、Lin, H. S.(2005)。Determinants of old-age mortality in Taiwan。Soc Sci Med,60,457-470。  new window
研究報告
1.行政院衛生署(2004)。中華民國92年衛生統計(一)--公務統計。台北:行政院衛生署。  延伸查詢new window
圖書
1.行政院主計處(2003)。中華民國台灣地區九十一年家庭收支調查報告。台北:行政院主計處。  延伸查詢new window
2.內政部統計處(2004)。中華民國台灣地區九十一年家庭收支調查報告。台北:內政部統計處。  延伸查詢new window
3.謝啟瑞(1996)。健康經濟學。臺北市:五南書局。  延伸查詢new window
4.Shryock, H. S.、Siegel, J. S.(1976)。The methods and materials of demography。New York。  new window
5.Box, George E. P.、Jenkins, Gwilym M.、Reinsel, Gregory C.(1994)。Time Series Analysis: Forecasting and Control。San Francisco, CA:Holden-Day。  new window
6.楊長興、蔡尚學、楊俊毓(2000)。就醫可近性對於國民健康之影響--「可避免死亡率」之趨勢分析。臺北。  延伸查詢new window
其他
1.中央健康保險局(1999)。健保局簡介,http://www.nhi.gov.tw/01intro/intro_1.htm, 2005/05/26。  延伸查詢new window
2.WHO(1998)。Health for all in the 21th century,http://www.euro.who.int/document/EHFA5-E.pdf, 2005/05/05。  new window
3.(2004)。World population data sheet,http://www.prb.org/pdfD4/04WorldDataSheet_Eng.pdf, 2005/01/06。  new window
 
 
 
 
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