醫療可近性對台灣地區中風病人死亡率的影響 ; The relationship between the accessibility and the mortality of apoplexy patients in Taiwan

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Title:	醫療可近性對台灣地區中風病人死亡率的影響;The relationship between the accessibility and the mortality of apoplexy patients in Taiwan
Authors:	黃羽瑄;Yu-Hsuan Huang
Contributors:	產業經濟研究所
Keywords:	中風;死亡率;距離;醫療可近性;mortality;apoplexy;accessibility;distance
Date:	2010-07-28
Issue Date:	2010-12-08 14:53:33 (UTC+8)
Publisher:	國立中央大學
Abstract:	本研究主要探討在控制個人特徵變數與健康情形後，醫療資源可近性（距離）對病人罹患中風後存活情況的影響。本文利用行政院衛生署中央健康保險局所發行的「2000年百萬人次抽樣檔」進行研究，我們將中風病人到醫院就診距離視為醫療可近性的指標，此為本文主要討論的重點，再加上就診醫院的特性和中風病人特徵等作為自變數，並使用線性機率模型（Linear Probability Model, LPM）進行實證分析。由於我們從抽樣資料中只能取得該樣本居住地與就醫地的鄉鎮市代碼，並無法判別病人居住地的真實住址，僅以該鄉鎮市代碼所代表的鄉鎮市區公所，當作樣本的居住地或就醫地的所在，所以距離衡量可能與實際情況有些落差。本文的實證結果發現，在控制醫院效果之下，病人到醫院距離越遠是導致中風病人發病後死亡率增加的主要原因。另外，我們病人中風當年的投保金額做為病人所得的代裡變數，表示投保金額越大，病人本身的經濟能力越佳，可發現當投保金額越大，該樣本中風後死亡率明顯呈現反向變動，換言之，病人本身經濟條件的確會影響個人患病後的健康產出因此本文建議政府或相關單位應將台灣各地醫療資源分佈失衡的情況納入考量，應地制宜制定適合的健保政策，如此一來可降低病人就醫的非貨幣成本，使全民健保更能貼近國人醫療需求，進而提升民眾的醫療品質。The purpose of this paper is to investigate the relationship between the accessibility and the mortality of apoplexy patients. The accessibility in this paper means that the distance from apoplexy patients’ home to the hospital. Base on the National Health Insurance Bureau claims data which the years of the data is from 1996 to 2007, we analyze these data, the distance and the characteristics of hospital and patients, for the mortality of apoplexy patients. Moreover, we apply Linear Probability Model to our paper. Finally, when we control the characteristics of hospital, the distance from apoplexy patients’ home to the hospital is the essential factor for the mortality of apoplexy patients. The farther distances are, the higher mortality of apoplexy patients is. Furthermore, we find that patients’ income is also an important effect for the mortality of apoplexy patients. However, we don’t get the true address of hospital and apoplexy patients’ home, the estimation of our paper may have some biases.
Appears in Collections:	[Graduate Institute of Industrial Economics] Electronic Thesis & Dissertation

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