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    題名: 臺灣都市化程度與醫療人力資源、醫療耗用及十大死因死亡率之相關;Correlation between Urbanization Level and Medical Consumption and Cause-specific Mortality Rates in Taiwan
    作者: 廖月香;Yueh-Hsiang Liao
    貢獻者: 中國醫藥大學:中國醫學研究所碩士班
    關鍵詞: 都市化程度;醫療人力資源;醫療耗用;十大死因死亡率;相關性研究;皮爾遜相關係數;urbanization Level;medical care consumption;ortality Rates
    日期: 2009-07-15
    上傳時間: 2009-08-10 16:01:07 (UTC+8)
    摘要: 目前台灣各縣市每萬人口中、西、牙醫師數的地理分布不均勻,是否影響醫療資源分布、醫療資源耗用、及疾病死亡率的差異? 所以本研究的目的是探討都市化程度與醫療資源分布、醫療資源耗用及疾病死亡率間的相關。
    本研究設計是以人口資料作為分析單位的相關性研究(correlational study),研究變項包括都市化程度指摽、醫療資源、醫療資源耗用、各縣市十大死因死亡率,以皮爾遜( Pearson’s )相關係數量化該地區都市化程度指摽和中、西、牙醫師數間的相關強弱,並以簡單線性迴歸建立以都市化程度預測中、西、牙醫師數和每位民眾平均每年的中醫、西醫、牙醫門診醫療費用的預估模式。
    研究結果顯示都市化程度與中、西、牙醫師數的皮爾遜( Pearson’s )相關係數,皆呈現中度至高度的負相關;都市化程度與醫療資源耗用間的相關,平均每位民眾每年的中醫、西醫、牙醫醫療消耗費用量的皮爾遜( Pearson’s )相關係數,亦皆呈現中度至強度的負相關,其中以牙醫師數與都市化程度的相關最強,西醫師數次之、中醫師數為最低。疾病死亡率前十名之死因依次為癌症、腦血管疾病、心臟病、糖尿病、意外事故、肺病、肝病、腎臟病、自殺、高血壓,其死亡率和該地區都市化程度指摽間呈現中度至強度的正相關(r值介於0.45~0.82之間),其中以意外事故死亡與都市化程度的相關最強,腦血管疾病死亡次之、心臟病死亡為第三位。
    有關醫療耗用每位中醫師門診申報費用與都化程度呈現中度正相關(0.41),但西醫及牙醫之醫療耗用幾乎沒有線性相關。
    這個結果顯示都市化程度較低的縣市,民眾有較低醫療資源及耗用,亦有較高的死亡率,執業的中醫師則有較高的申報費用,本研究所呈現的結果,可提供國家醫療行政單位,對未來中、西、牙醫師人力規劃政策及醫療資源分配的考量。

    The objective of this study is to investigate the relationship between level of urbanization, medical care consumption per resident for Western and Chinese medicine and dentists care, and cause-specific mortality rates in counties of Taiwan. A correlational study was used with county data as units of analysis. Variables included level of urbanization index, mean annual outpatient visits for Western and Chinese medicine and dentists care per resident, and mortality rates for ten leading causes of death. The Pearson’s correlation coefficients were used.
    Results of Pearson’s correlation coefficients indicated there was moderate to high negative correlation between the level of urbanization and mean annual outpatient visits for Western and Chinese medicine and dentists care per resident (Chinese medicine care: -0.65, Western medicine care: -0.67; dentist care: -0.73). The highest three causes of mortality are cancer, cardiovascular disease, and heart disease in 2006. Moderate to strong positive correlation was found between mortality rates for ten leading causes of death and the level of urbanization. The strongest correlation was found for accidental death (r=0.82), next for cardiovascular disease (r=0.79), and third for heart disease (r=0.70).
    Our results indicate that areas with a lower level of urbanization have lower levels of medical resource consumption per resident for Western and Chinese medicine and dentists care, and higher disease mortality rates. The administrative health authorities in Taiwan should pay attention to the imbalance of medical resources and consumption in counties of various level of urbanization as indicated by this study and have actions on it.
    顯示於類別:[中國醫學研究所] 博碩士論文

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