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| Title: | 我國醫療與長照資源可近性分析： 剝奪擴大的觀點
Access to healthcare and long-term care analysis: deprivation amplification perspective |
| Authors: | 廖明俊
Liao, Ming-Jun |
| Contributors: | 廖興中
Liao, Hsin-Chung
廖明俊
Liao, Ming-Jun |
| Keywords: | 醫療資源
長照資源
可近性
進階兩階段流動搜尋法
Healthcare
Long-term care
Accessibility
E2SFCA |
| Date: | 2023 |
| Issue Date: | 2023-03-09 18:36:21 (UTC+8) |
| Abstract: | 醫療資源以及長照資源已然於被認為是維持個人生命尊嚴的基本權利，而當中醫療與長照資源的可近性更關乎於個人是否能夠取得服務，然而不同區域之間的分佈上時常具有資源落差，致使部分的偏鄉地區產生可近性不佳的問題，我國亦不例外。除了可近性不佳的情況之外，偏遠地區更可能具備收入、教育程度、年齡、種族等弱勢特質，是以這些偏鄉地區民眾的剝奪狀況容易受到擴大，此極為剝奪擴大之概念，總的來說，本研究旨在分析我國各地區醫療、長照資源的可近性，並探討是否有剝奪擴大的發生。
本研究將以地理資訊系統進行分析，並利用地圖之方式輔以呈現，首先，可近性之計算上將以「進階兩階段的流動搜尋法」進行分析，另再以單因子變異數分析之方式，以前述的弱勢因素作為自變項，而可近性作為依變項分析，探討是否有剝奪擴大之情形，最後再以集群分析之方式，探究不同地區剝奪擴大的程度。
分析的結果顯示出，無論是醫療或是長照資源均集中分佈於西半部的地區的傾向，不過A、C據點於非都市地區的分佈確實較醫療資源以及B據點來得好。另剝奪擴大的分析結果顯示出，醫療資源對於上述弱勢因素具有明顯的剝奪擴大效應，而B據點則係於收入與教育程度上有顯著的剝奪擴大，最後，集群分析的結果顯示出各縣市的非都會地區受到剝奪擴大的程度均較明顯。
本研究分別針對政策以及後續的研究提出以下建議，首先，政策面向上建議醫療資源可以借鏡C據點的機構配置，以精緻化的分級制度縮減規模，減少投入成本，使醫療資源能夠深入偏鄉地區，並減少剝奪大擴大的狀況，而研究面向建議可以再將醫療科別、長照的服務內容分門別類，搭配特定的需求人口進行分析，使分析的結果可以更精準。
Resources of healthcare and long-term care are already regarded as basic rights that could maintain the dignity of human life. Among them, the accessibility to healthcare and long-term care is more related to whether humans can get service. However, there are often resource gaps in different region, resulting in poor accessibility in some rural areas, and Taiwan is no exception. In addition to poor accessibility, remote areas are more likely to have disadvantaged characteristics such as income, education, age, and race. Therefore, the status of deprivation of people in this remote area is amplified, called deprivation amplification. In summary, this research aims to analyze the accessibility of healthcare and long-term care resources in various regions of Taiwan and to explore whether there is deprivation amplification.
This research would use GIS for analysis and present the results with maps. First, the accessibility would be calculator through enhanced two-step floating catchment area (E2SFCA) method, then explore the deprivation amplification with ANOVA. The aforementioned underprivileged factors as independent variables, and accessibility as dependent variable. Finally, this research would analyze the extent of deprivation amplification in each region of Taiwan with cluster analysis.
The results show that both healthcare and long-term care resources tend to be allocated in the western region. However, the accessibility of A and C bases in non-urban areas is indeed better than healthcare resources and B bases. In addition, the analysis results of deprivation amplification show that healthcare resources have a significant deprivation amplification effect on the above-mentioned underprivileged factors, and base B has significant deprivation amplification to income and education factors. Finally, cluster analysis results show that the deprivation amplification of each county in non-urban areas is more evident than in urban areas.
There are two suggestions for the policy and follow-up research. First, for the policy, the healthcare system could learn from the allocation of C base downsizing and reducing the cost with a sophisticated rating system that enables resources to provide service in rural areas, then reduce the deprivation amplification. Second, for research orient, follow-up research can classify the service content of healthcare and long-term care because analysis with specific population needs can make analysis results more accurate. |
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| Description: | 碩士
國立政治大學
公共行政學系
109256026 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0109256026 |
| Data Type: | thesis |
| Appears in Collections: | [公共行政學系] 學位論文
|
Files in This Item:
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Description |
Size | Format | |
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| 602601.pdf | | 7667Kb | Adobe PDF2 | 122 | View/Open |
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