慢性病對勞動參與的影響-以勞保和公保洗腎患者為例;The Impact of Chronic Diseases on Labor Participation：A case study of labor and civil servant insurance patients with dialysis

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题名:	慢性病對勞動參與的影響-以勞保和公保洗腎患者為例;The Impact of Chronic Diseases on Labor Participation：A case study of labor and civil servant insurance patients with dialysis
作者:	徐慧玲;Hsu, Hui-Ling
贡献者:	產業經濟研究所在職專班
关键词:	慢性病;勞動參與;洗腎;DID;chronic diseases;labor participation;dialysis;DID
日期:	2016-12-27
上传时间:	2017-01-23 17:07:16 (UTC+8)
出版者:	國立中央大學
摘要:	近年因社會進步，國家科技發達，投入勞動市場的人力也因為工作的壓力，生活飲食習慣的改變，使得越來越多的人身體健康遭受威脅，不知不覺罹患了各種身心疾病，使得台灣的慢性病患人數年年增加，而慢性病的疾病症狀也越來越多元。台灣的洗腎人口在1995年突然暴增，除了是實施全民健康保險提供了重大傷病制度的推動，免除患者看診的部分負擔，使得大部分的慢性腎臟病患者都可以接受到診治外，一方面也是因為慢性腎臟病是許多慢性病的共病，提高了洗腎病患的數量，而洗腎不僅會導致身體健康狀態改變，也容易降低工作意願及能力。本文透過國家衛生研究院發行之全民健康保險資料庫，採用2000年及2005年百萬人次抽樣檔，選取1996年至2013年間洗腎的患者，以勞保為實驗組，公保為控制組，互為對照，並進一步採用計量上差異中的差異估計法（Difference-in-Difference，簡稱DID），分析勞保和公保洗腎患者對其勞動參與及所得的影響。研究結果顯示，洗腎確實會對就業產生負面影響，在洗腎後繼續存活的患者中，勞保相較於公保的洗腎患者，在洗腎後第1年就業率下降11.68%，到了洗腎後第3年就業率更是下降到15.72%，而就所得面來看，洗腎患者在洗腎後仍持續就業者，其所得水準及變動率，並未隨著洗腎年數的延長而有明顯下降的傾向，另外，洗腎後因身體健康受到影響，男性相較於女性更容易選擇退出就業，但情況並不明顯。 ;In recent years, the developments in society and technology have brought prosperity. However, pressure of work and the change in diet have put more and more people under the threat of physical and mental diseases. The number of suffering from chronic diseases is increasing and the symptoms of chronic diseases are various. In 1995, there was a sudden increase in dialysis population. One of the reasons is the implementation of the National Health Insurance system, which offered copayment exemptions, making most patients with chronic kidney diseases able to afford the treatment. The other reason is that chronic kidney diseases are the common symptoms of many other chronic diseases, which increases the number of dialysis patients. Dialysis not only leads to changes in physical health but also reduces patients’ willingness and ability to work. In this study, we used the national healthy insurance database published by the National Institutes of Health, using 2000 and 2005 million sample files to select patients who had renal dialysis between 1996 and 2013, labor insurance as the experimental group and civil servant insurance as the control group. DID was used to analyze the influence on labor participation and income of dialysis patients. The study shows that dialysis does have a negative impact on the employment of dialysis patients who have survived dialysis. Compared to the dialysis patients with labor insurance, the employment rate of those with civil servant insurance declines by 11.68% in the first year and by 15.72% in the third year. As for the income level and change rate, both of which do not decline obviously with the extension of time for dialysis. In addtion, because of their health condition, men are more likely than women to quit their iob. But the situation is not obvious.
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