雪山隧道通車對宜蘭縣肝癌、肺癌及胃癌病患醫療結果之影響

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Title:	雪山隧道通車對宜蘭縣肝癌、肺癌及胃癌病患醫療結果之影響
Authors:	陳彥成;Chen,Yen-Cheng
Contributors:	產業經濟研究所
Keywords:	醫療可近性;雪山隧道;癌症;死亡率;Accessibility of health care;Hsuehshan Tunnel;cancer;mortality rate
Date:	2013-08-16
Issue Date:	2013-10-08 15:18:57 (UTC+8)
Publisher:	國立中央大學
Abstract:	本文旨在觀察雪山隧道開通後，對宜蘭縣肝癌、肺癌及胃癌患者醫療結果的影響。研究中以雪山隧道開通作為實驗虛擬變數，利用2002年至2010年全民健保資料庫中，宜蘭縣、台北市以及花蓮縣的肝癌、肺癌及胃癌病患資料，利用差異間之差異法，兩兩比較不同縣市中罹患相同癌症的患者其醫療結果的平均差異。實證結果發現雪山隧道通車後，宜蘭縣的肝癌患者的12個月內與18個月內死亡率顯著下降，但對於肺癌患者的影響並不顯著，而胃癌患者的24個月內死亡率反有顯著上升。由於肝癌是本研究的三種癌症中，病患較能夠承受積極治療的癌症，而宜蘭縣不僅僅因雪山隧道通車提升了當地的醫療可近性，亦為宜蘭縣帶來了外來醫療資源的挹注與人力交流，在在都對宜蘭縣當地的醫療水平有所提升，使宜蘭縣的肝癌病患在雪山隧道開通後，醫療結果有所改善而使病患生命延長。而肺癌及胃癌的患者則由於疾病本身不易早期發現，且中晚期死亡率高的特性，使得宜蘭縣的肺癌及胃癌病患，即便在宜蘭縣的整體平均醫療水平上升後，也沒有改善。 This paper aimed at whether there was an improvement in the treatment outcomes of liver, lung and stomach cancer patient in Yilan afer the Hsuehshan Tunnel opening completed on June 16, 2006. By using the 2002-2010 National Health Insurance Database, we estimated and compared the changes in the 6 month, 12month, 18month and 24 months mortality rate of liver, lung and stomach cancer patient in Yilan, Taipei and Hualian via the OLS regression model and difference-in-differences model. We found that 12-month and 18-month mortality rates for liver cancer patients in Yilan did decline after the opening of the Hsuehshan Tunnel, but not statistically significant for lung and stomach cancer patient. The treatment outcomes for Yilan's liver cancer patients did improve after the opening of the Hsuehshan Tunnel. The opening of the Hsuehshan Tunnel improved not only the accessibility of medical service but also the migration of medical manpower in Yilan.
Appears in Collections:	[Graduate Institute of Industrial Economics] Electronic Thesis & Dissertation

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