| 摘要: | 目的：探討民眾對成人預防保健實施的瞭解程度、接受度及滿意度，同時探討民眾對預防保健的認知及態度，並分析影響接受成人預防保健相關因素。此外分析成人預防保健服務的成本效果。方法：本研究以結構式問卷分別調查接受過及未接受過成人預防保健服務者，並依在醫院層級別的檢查比例，於1家醫學中心、2家區域醫院、3家地區醫院及41 家診所進行收案，共收集接受檢查者問卷523份，未曾接受檢查者507份，共1,030份有效問卷。此外藉由已收集的10,135份成人預防保健服務檢查單上的檢查結果，分析發現疑似異常個案的成本效果。結果：教育程度高、家庭月收入高、有固定就醫場所者，對預防保健服務的認知與瞭解程度越好；血液檢查、尿液檢查的確實性最高，而直腸肛診與乳房檢查的執行率則不到30％；影響民眾是否接受預防保健服務的因素則包括年齡、教育程度、家庭收入、有固定就醫場所、有相關疾病史、認知定期健康檢查的必要性以及對預防保健服務檢查項目的瞭解程度；影響滿意度的相關因素則包括年齡、教育程度、家庭收入、有固定就醫場所、定期健康檢查的必要性、對檢查項目的瞭解程度、檢查結果正確性的認知以及接受檢查的醫院。在成本效果的部分，以血壓、血脂、血糖、心臟與肝功能異常等其每新發現一位疑似疾病異常的個案，所需花費的成本為 873元，若以單項成本來計算單項疾病的成本效果，則新發現血壓異常的成本為22～29元，血糖異常的成本為615～810元，血脂異常的成本為 222～276元、心臟異常的成本為803～966元、肝功能異常的成本為554～753元。結論：個人特性、經濟狀況、就醫行為及預防保健的認知等對是否曾接受成人預防保健與接受後的滿意度皆有顯著影響。成人預防保健服務新發現血壓、血糖、血脂、心臟或肝功能任一項異常具有一定的成本效果。
Objectives: This study investigated general population’s understanding, acceptance, and satisfaction for the adult health examination (AHE) provided by Government. General population’s perception and attitude toward health prevention would be examined. The factors associated with taking AHE would be analyzed. In addition, cost effectiveness analysis (CEA) was conducted for AHE. Methods: This study used structured questionnaire to survey general population who used or never used AHE. The sample was selected from four-level medical care organizations according to the proportion of AHE used in each level medical care organization. A total of 523 questionnaires from people using AHE and 507 questionnaires from people never using AHE were collected from one medical center, 2 regional hospitals, 3 local hospitals, and 41 clinics. Moreover, 10135 AHE sheets have been collected to be used for cost effectiveness analysis. Results: People with higher education, higher family income, and having a regular care medical facility would have better perception and understanding for health prevention. Both blood exam and urine exam have conducted much completely, whereas less than 30% of breast exam and of rectum/rectal touch exam have been done. The factors associated with doing AHE consisted of age, education, family income, yes/no regular care facility, related diseases, perception on importance of regular health examination, and understanding the exam items of AHE. The factors influencing AHE satisfaction included age, education, family income, yes/no regular care facility, perception on importance of regular health examination, and understanding the exam items of AHE, perception on correction of AHE results, and facilities doing AHE. As for CEA, an average cost of 873 NTD for finding any one new abnormal case for blood pressure, blood sugar, Lipemia, heart, or liver function. Separately, The cost for finding an abnormal case for blood pressure is 22-29 NTD, for blood sugar is 615-810 NTD, for Lipemia is 222-276 NTD, and for heart is 803-966 NTD, and for liver function is 554-753 NTD. Conclusion: The factors related to personal characteristic, income, medical care behaviors, and perception on health prevention would significantly influence to take AHE and the satisfaction with AHE. There was a good cost effectiveness for blood pressure, blood sugar, Lipemia, heart, liver function examined by AHE. |
