| 摘要: | 中醫醫療長久以來一直是台灣民眾醫療保健重要的方式之一，中醫師人力數量與品質直接影響民眾的醫療需求是否能夠得到滿足，在過去中醫師人力資源的相關研究結果顯示：(1)中醫師人力嚴重地理分布不均(2)中醫師人力成長比預期時間超前(3)中醫師人力有供給過剩的現象。中醫師人力的有關研究數量甚少，且以往之研究均在中醫門診總額支付制度實施之前，距今也有一段時日，中醫門診總額支付制度開辦至今即將屆滿七年，應有必要針對中醫師人力資源重新進行研究。本研究目的在於： 1. 中醫門診總額支付制度實施前後，中醫師人力地理分布的變遷之調查與分析。 2. 推估未來10年台灣中醫師人力供給與需求推估。 3. 收集國內醫師、牙醫師人力分布資料及國內外醫師人力規劃資料。 4. 對未來中醫師人力規劃政策提供具體建議。本研究資料來源為中華民國中醫師公會所屬會員公會會員通訊錄、衛生署中醫師人力檔、全民健保中醫醫事機構基本檔(1995-2006)，中華民國台閩地區人口統計月報(1995-2006)，中華民國衛生統計資料(1995-2006)，及全民健保中醫門診費用申請總表主檔(199501~200612) 等資料。 本研究以經濟學上探討所得分布是否平均的方法(Lorenz curve 和 Gini coefficient)、中醫師人口比平均值、變異係數、中醫師不足鄉鎮數、與無中醫鄉鎮數等五項指標分析台灣地區1995年至2006年中醫師人力分布的變遷情形，另並針對全民健保開辦初期（1995年）、中醫總額實施初期（2000年）及中醫總額實施後5年（2005年）三個時期中醫師、西醫師、牙醫師人力地理分布吉尼係數之變化(各縣市)進行分析比較，以經建會(1994)全民健康保險制度規劃技術報告的方法，推估未來十年(2007-2017) 台灣中醫師人力供給，並以2005年全民健保醫療統計年報中醫不同性別、年齡層平均就診次數，經建會未來人口推計變化，推估未來十年中醫醫療利用需求。收集分析比較國內醫師、牙醫師及國外OECD主要國家醫師人力規劃政策，最後彙整上述資料，對未來中醫師人力規劃提供具體建議。
For a long-term period, the Chinese medical treatment is one of the important ways for people in Taiwan to take care of their health. The manpower quantity and quality of Chinese medical affect directly to the satisfaction of the people needed for medical treatment. In the past, the relative studies of human resource of the Chinese medical in Taiwan have shown that: (1) A serious uneven geographical distribution of the manpower of Chinese medical (2) The growth of human resource of the Chinese medical is ahead under expected schedule time (3) The manpower of the Chinese medical has a phenomena of over supply. There were less relative studies about manpower of the Chinese medical in Taiwan, and all previous studies were done before the implementation of global budget system. Since then, there are already seven years long after the global budget system is implemented. It is necessary for us to do a new research on human resource of the Chinese medical. The aims of this study are: 1. To investigate and analyze on the change of geographical distribution of human resource for the Chinese medical before and after the global budget system. 2. To forecast the supply and demand of human resource for the Chinese medical in the future ten years of Taiwan. 3. To collect domestic and foreign information data about human resource programming. 4. To provide a concrete suggestion for future human resource programming of the Chinese medical. The data resources of this study come from the member directory of the ROC Chinese Medical Association, the manpower file of the Chinese medical, Department of Health, Executive Yuan, R.O.C. (Taiwan), the Basic File (1995-2005) of the Medical Care Institutions of National Health Insurance, the Monthly Report of Taiwan-Fuchien Demographic Fact Book Republic of China (1995-2005), the data of Republic of China Health and Vital Statistics (1995-2005), and the Main File (199501-220512) of Application Form of Global Budget System, National Health Insurance, etc. Based on the Economics, the results of this study are to analyze and see if an even distribution (Lorenz curve and Gini coefficient), population proportion average, variable coefficient of Chinese medical, insufficient quantity of Chinese medical in the townships, and no Chinese medical in the townships, etc. the five indexes will affect to the change of human resource distribution of the Chinese medical in Taiwan from 1995 to 2005. With technological report of the National Insurance System Programming, the Council for Economic Planning and Development, Executive Yuan (1994), the manpower supply of Chinese medical in Taiwan of future ten years (2007-2017) was forecasted. Also, the Chinese medical demand and utilization in the future ten years of Taiwan could be predicted according to the medical statistics from annual report of 2005 National Insurance System at different sex, average age for medical treatment times, and future population change record from the Council for Economic Planning and Development, Executive Yuan. Under data collection, analysis, and comparison the domestic doctors, dentists, and foreign OECD human resource planning policies of the medicine, this study has provided a specific and concrete suggestion for future programming of human resource of the Chinese medical. |
