全民健康保险第一保险对象之医用研究以区分局辖区为.pdfVIP

全民健康保險第一類保險對象之醫療利用研究- 以北區分局轄區為例 許碧芳 高青莉 Pi-Fang Hsu and Zhin-Li Kao 元培科學技術學院 經營管理研究所 Graduate Institute of Business and Management, Yuanpei University 摘 要 全民健康保險中第一類投保人口佔總投保人口一半以上，以量化的角度而 言，其醫療資源之使用，必定與健保費支出有其重要的關聯性。呼吸系統疾病其 門診人數、 人次統計均為所有疾病類別中最多(以國際疾病分類第九版為基礎)， 其所形成之醫療資源與費用實為可觀。因此，若能了解患有呼吸系統疾病之第一 類人口的醫療使用特性，並採取適當措施，將對醫療費用的撙節助益不小。本研 究目的在了解健保局北區分局轄區患有呼吸系 統疾病之第一類保險人口之醫療 資源耗用情形。研究結果發現，不同人口學變數在不同的醫療服務利用上有所不 同。而本研究描述了樣本對象醫療資源之利用的特性，研究分析結果將做為未來 健保政策提供初步建議之參考。 關鍵詞： 全民健康保險，第一類保險對象，醫療利用，呼吸系統疾病。 1 Exploring the Utilization of Healthcare Resources in Taiwan: Case Study of First Category Insured in Northern Region Branch of Burean National Health Insurance ABSTRACT Although implementation of the national health insurance (NHI) scheme in Taiwan has ensured that over 97% of all residents are under coverage, inefficient utilization of medical resources and rapid expansion of NHI-related medical expenditures have severely strained governmental and societal resources. This study analyzes the utilization of healthcare resources for first category insured diagnosed with respiratory system diseases in the Northern Region Bureau of National Health Insurance (NRBNHI) in Taiwan. This study adopts two statistical analysis approaches: independent two sample t-test and one-way analysis of variance (one-way ANOVA). Results of this study provide a valuable reference for governmental authorities in formulating policies and understanding demographic characteristics. Keywords: National health insurance, first category insured, healt